Chest
Clinical Investigations in Critical Care COPDControlled Short-term Trial of Fluticasone Propionate in Ventilator-Dependent Patients With COPD
Section snippets
Patients
Ventilator-dependent patients with COPD, as defined by AmericanThoracic Society criteria,7 were enrolled in this study, which had been approved by the local ethics committee. Oral informedconsent was given by each patient. The patients had been consideredeligible for receiving long-term ventilation in one of their previousadmissions to our respiratory ICU. Briefly, at the time of an episodeof severe acute respiratory failure, patients were intubated in one of the five ICUs connected to our
Results
All the enrolled patients completed the study, and none of themshowed any side effects due to the aerosol administration. Inparticular, serum glucose levels, arterial BP, and heart frequency werenot affected by FP or placebo.
Table 2shows the values of RM recorded on day 1. PEEPi, st was present in allthe patients and varied from 1.2 to 9.6 cm H2O. Cst, rs was, on average, higher than that reported for healthysubjects22 and was similar to the values obtained in COPDpatients receiving mechanical
Discussion
In this study, we have demonstrated for the first time (to ourknowledge), as objectively assessed by the recording of passive RM, that in severely ill, ventilator-dependent COPD patients with chronicrespiratory failure who are in stable condition, a topical steroid (FP)that is administered for a brief period may improve the degree of airway obstruction.
The benefit of the administration of systemic corticosteroids topatients in stable condition with COPD is controversial even though, ina
ACKNOWLEDGMENT
We wish to thank Dr. R. C. Stenner for reviewing the English grammar in this article.
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