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Esmolol and ventilatory function in cardiac patients with COPD.
M R Gold1, G W Dec, D Cocca-Spofford
1Cardiac Unit, Massachusetts General Hospital, Boston.
Chest
|November 1, 1991
Summary
Acute cardioselective beta blockade using esmolol in patients with COPD and cardiac issues showed minimal impact on lung function. This treatment appears safe, with low risk of bronchospasm in this patient group.
Area of Science:
- Cardiology
- Pulmonology
- Pharmacology
Background:
- Patients with Chronic Obstructive Pulmonary Disease (COPD) often have co-existing cardiac disorders.
- Beta-blockers are crucial for cardiac conditions but raise concerns about respiratory side effects in COPD patients.
- Cardioselective beta-blockers are preferred for their targeted cardiac action.
Purpose of the Study:
- To evaluate the acute effects of cardioselective beta blockade on ventilatory function in COPD patients with cardiac disorders.
- To assess the safety and tolerability of esmolol infusion in this specific patient population.
Main Methods:
- Fifty patients with COPD and active cardiac disorders were enrolled.
- Intravenous infusion of esmolol (8 to 24 mg/min) was administered.
- Pulmonary function tests were conducted to assess ventilatory parameters before and during infusion.
Main Results:
- Esmolol significantly reduced heart rate and systolic blood pressure (p < 0.01).
- No significant group effect of beta blockade on overall pulmonary function was observed.
- No patients reported dyspnea or wheezing; only 6% experienced asymptomatic decreases in FEV1.
Conclusions:
- Acute beta blockade with esmolol is hemodynamically effective in COPD patients with cardiac disorders.
- Esmolol administration demonstrated a low risk of significant bronchospasm in this cohort.
- Cardioselective beta blockade with esmolol appears to be a safe option for managing cardiac conditions in COPD patients.