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Lung

, Volume 184, Issue 6, pp 335–339 | Cite as

Salmeterol Improves Pulmonary Function in Persons with Tetraplegia

  • David R. Grimm
  • Gregory J. Schilero
  • Ann M. Spungen
  • William A. Bauman
  • Marvin Lesser
Article

Abstract

β2-Adrenergic agonists are known to improve muscle strength because of anabolic properties. The purpose of this study was to determine if long-term administration of a long-acting β2-adrenergic agonist to subjects with tetraplegia is associated with improvement in pulmonary function parameters and maximal static inspiratory and expiratory mouth pressures (MIP and MEP, respectively), measures of respiratory muscle strength. The study was a randomized, prospective, double-blind, placebo-controlled, crossover trial and conducted at the James J. Peters Veterans Affairs Medical Center. Thirteen subjects who had complete or incomplete tetraplegia for more than one year participated in the study. Eleven subjects completed the study. All were clinically stable outpatients without any history of asthma or use of inhaled bronchodilators. Following baseline measurements, patients were randomized to receive salmeterol or placebo from identically marked Diskus containers for 4 weeks. Following a 4-week washout period, the subjects were randomized to receive the alternate preparation for 4 weeks. Pulmonary function parameters and static mouth pressure were measured during baseline and during the fourth week of the two study periods. During the 4-week period of salmeterol administration, forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow, MIP, and MEP improved significantly compared with placebo and baseline. Expiratory reserve volume increased significantly compared to baseline. Increases in MIP and MEP during salmeterol administration suggest improvement in respiratory muscle strength. However, this cannot be stated with certainty because MIP and MEP are dependent on volume parameters at which they are measured. Regardless of the mechanism, improvement in static mouth pressures indicates that salmeterol should benefit these individuals by improving cough effectiveness.

Keywords

Spinal cord injury Spirometry Bronchodilator Respiratory muscle strength Salmeterol Tetraplegia 

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • David R. Grimm
    • 2
  • Gregory J. Schilero
    • 1
    • 3
    • 5
    • 7
  • Ann M. Spungen
    • 3
    • 4
    • 5
    • 6
    • 7
  • William A. Bauman
    • 3
    • 4
    • 5
    • 6
    • 7
  • Marvin Lesser
    • 7
  1. 1.Center for the Medical Consequences of Spinal Cord InjuryJames J. Peters Veterans Affairs Medical CenterBronxUSA
  2. 2.Basic Sciences DepartmentNew York Chiropractic CollegeSeneca FallsUSA
  3. 3.Department of MedicineMount Sinai School of MedicineNew YorkUSA
  4. 4.Department of Rehabilitation MedicineMount Sinai School of MedicineNew YorkUSA
  5. 5.Medical ServiceJames J. Peters Veterans Affairs Medical CenterBronxUSA
  6. 6.Spinal Cord Injury ServiceJames J. Peters Veterans Affairs Medical CenterBronxUSA
  7. 7.Center for the Medical Consequences of Spinal Cord InjuryJames J. Peters Veterans Affairs Medical CenterBronxUSA

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