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The β-Agonist Lung Injury Trial (BALTI)
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Perkins, Gavin D., McAuley, Daniel F., Thickett, David R. and Gao, Fang (2006) The β-Agonist Lung Injury Trial (BALTI). American Journal of Respiratory and Critical Care Medicine, 173 (3). pp. 281-287. doi:10.1164/rccm.200508-1302OC ISSN 1073-449X.
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Official URL: http://dx.doi.org/10.1164/rccm.200508-1302OC
Abstract
Rationale: Experimental data suggest that manipulation of alveolar fluid clearance with β-agonists can accelerate the resolution of alveolar edema and improve survival. Objective: To determine if a sustained infusion of intravenous salbutamol (albuterol) would accelerate the resolution of alveolar edema in adult patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Methods: This was a single-center, double-blind, randomized controlled trial. Patients with ALI/ARDS were randomized to treatment with intravenous salbutamol (15 μg kg-1 h-1) or placebo for 7 d. The primary endpoint was extravascular lung water measured by thermodilution (PiCCO) at Day 7. Measurements and Main Results: Sixty-six patients were screened; of these, 40 met the inclusion criteria and were enrolled during 2001-2003. Patients in the salbutamol group had significantly lower lung water at Day 7 than the placebo group (9.2 ± 6 vs. 13.2 ± 3 ml kg-1; 95% confidence interval difference, 0.2-8.3 ml kg-1; p = 0.038). Plateau airway pressure was lower at Day 7 in the salbutamol group (23.9 ± 3.8 cm H2O) versus placebo (29.5 ± 7.2 cm H2O; p = 0.049). There was a trend toward lower Murray lung injury score at Day 7 in the salbutamol group (1.7 ± 0.9) versus placebo (2.0 ± 0.6; p = 0.2). Patients in the salbutamol group had a higher incidence of supraventricular arrhythmias (26 vs. 10%; p = 0.2). Conclusion: Although further research is required to confirm the efficacy and safety of intravenous salbutamol in ALI/ARDS, this trial provides the first proof of principle that, in humans with ALI/ARDS, sustained treatment with intravenous β-agonists reduces extravascular lung water.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > R Medicine (General) | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | American Journal of Respiratory and Critical Care Medicine | ||||||
Publisher: | American Thoracic Society | ||||||
ISSN: | 1073-449X | ||||||
Official Date: | 1 February 2006 | ||||||
Dates: |
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Volume: | 173 | ||||||
Number: | 3 | ||||||
Page Range: | pp. 281-287 | ||||||
DOI: | 10.1164/rccm.200508-1302OC | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Restricted or Subscription Access |
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