Priya Preeti, Nath Soumya S, Kumar Virendra, Kumar Suraj
Department of Anaesthesiology and Critical Care Medicine, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Indian J Crit Care Med. 2024 Oct;28(10):963-969. doi: 10.5005/jp-journals-10071-24806. Epub 2024 Sep 30.
The present study examined the duration of bronchodilation induced by nebulized glycopyrronium bromide (GB) and compared its effectiveness and incidence of any side effects with the combination of salbutamol and ipratropium bromide (SI) in critically ill mechanically ventilated chronic obstructive pulmonary disease (COPD) patients.
This prospective, observational study was conducted in mechanically ventilated adult patients of COPD (18-75 years). Data of two groups of patients were collected for 12 hours each for three consecutive days after the nebulization - Group I: those who received 25 µg of GB, and Group II: those who received 1.25 mg of levo-salbutamol and 500 µg of ipratropium by nebulization.
A significantly higher number of patients in group II had copious secretions. The mean static compliance was comparable at all time intervals, whereas the mean airway pressure was significantly lower in group II from 15 minutes to 4 hours post-nebulization. In group I, the onset of bronchodilation was 30 minutes on days 1 and 3, and 60 minutes on day 2, whereas, in group II, it was 60 minutes on days 1 and 2 and 30 minutes on day 3. In group I, bronchodilation was 10 hours on day 1 and 12 hours each on days 2 and 3, whereas in group II, bronchodilation was 4 hours on day 1 and 6 hours each on day 2 and 3.
Compared with SI, GB nebulization resulted in lesser respiratory secretions, a longer duration of action in terms of lowered airway resistance, and no adverse effects like hypertension, tachycardia, or desiccation of respiratory secretions.
Priya P, Nath SS, Kumar V, Kumar S. Comparison of Nebulized Glycopyrronium with a Combination of Salbutamol and Ipratropium on Ventilatory Parameters in Critically Ill Mechanically Ventilated Patients of Chronic Obstructive Pulmonary Disease: An Observational Study. Indian J Crit Care Med 2024;28(10):963-969.
本研究检测了雾化吸入格隆溴铵（GB）引起支气管扩张的持续时间，并比较了其与沙丁胺醇和异丙托溴铵联合使用（SI）在机械通气的重症慢性阻塞性肺疾病（COPD）患者中的有效性及任何副作用的发生率。
本前瞻性观察性研究在机械通气的成年COPD患者（18 - 75岁）中进行。雾化吸入后连续三天，每天收集两组患者12小时的数据——第一组：接受25μg GB的患者；第二组：接受1.25mg左旋沙丁胺醇和500μg异丙托溴铵雾化吸入的患者。
第二组有大量分泌物的患者数量显著更多。在所有时间间隔，平均静态顺应性相当，而在雾化吸入后15分钟至4小时，第二组的平均气道压力显著更低。在第一组，第1天和第3天支气管扩张的起效时间为30分钟，第2天为60分钟；而在第二组，第1天和第2天为60分钟，第3天为30分钟。在第一组，第1天支气管扩张持续10小时，第2天和第3天各持续12小时；而在第二组，第1天支气管扩张持续4小时，第2天和第3天各持续6小时。
与SI相比，雾化吸入GB导致呼吸道分泌物更少，在降低气道阻力方面作用持续时间更长，且无高血压、心动过速或呼吸道分泌物干燥等不良反应。
Priya P, Nath SS, Kumar V, Kumar S. 雾化吸入格隆溴铵与沙丁胺醇和异丙托溴铵联合使用对机械通气的重症慢性阻塞性肺疾病患者通气参数的比较：一项观察性研究。《印度重症监护医学杂志》2024；28(10):963 - 969。
