[Nebulization in worsening of chronic obstructive lung diseases: importance of anticholinergic agents. The...

COPD exacerbations frequently require an hospitalization. Hospital management of severe exacerbations is based upon their initial severeness; an emergency treatment of bronchospasm is mandatory, in ICU if necessary. A French multicenter study, including 54 patients, was designed to determine the optimal number of ipratropium nebulizations in COPD exacerbations, together with intravenous corticosteroids. The response rate to treatment was 100% after 48 hours; the number of nebulizations for each patient was often high, in average 6 to 7. Evolution of haemodynamic parameters (cardiac rate and blood pressure) was satisfactory. It was impossible to point up any initial predictive factor. The authors, in conclusion, explain the best strategy to choose a bronchodilator treatment.