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Does β2-Agonist Use Improve Survival in Critically Ill Patients with Acute Respiratory Distress Syndrome?

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Reducing Mortality in Critically Ill Patients

Abstract

Although preliminary data suggest that use of β2-agonist in the context of ARDS could potentially accelerate alveolar edema clearance and have beneficial anti-inflammatory and immunomodulatory effects, robust prospective clinical trials demonstrated that use of β2-agonists in ARDS patients is unlikely to be beneficial and could worsen outcomes. Routine administration of β2-agonists in mechanically ventilated critically ill patients with ARDS should therefore be avoided.

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References

  1. Rubenfeld GD, Caldwell E, Peabody E et al (2005) Incidence and outcomes of acute lung injury. N Engl J Med 353:1685–1693

    Article  CAS  PubMed  Google Scholar 

  2. Matthay MA, Ware LB, Zimmerman GA (2012) The acute respiratory distress syndrome. J Clin Invest 122:2731–2740

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Mutlu GM, Sznajder JI (2005) Mechanisms of pulmonary edema clearance. Am J Physiol Lung Cell Mol Physiol 289:685–695

    Article  Google Scholar 

  4. Mutlu GM, Adir Y, Jameel M et al (2005) Interdependency of beta-adrenergic receptors and CFTR in regulation of alveolar active Na1 transport. Circ Res 96:999–1005

    Article  CAS  PubMed  Google Scholar 

  5. Sartori C, Allemann Y, Duplain H et al (2002) Salmeterol for the prevention of high-altitude pulmonary edema. N Engl J Med 346:1631–1636

    Article  CAS  PubMed  Google Scholar 

  6. Manocha S, Gordon AC, Salehifar E et al (2006) Inhaled beta-2 agonist salbutamol and acute lung injury: an association with improvement in acute lung injury. Crit Care 10:R12

    Article  PubMed Central  PubMed  Google Scholar 

  7. Perkins GD, McAuley DF, Thickett DR, Gao F (2006) The beta-agonist lung injury trial (BALTI): a randomized placebo-controlled clinical trial. Am J Respir Crit Care Med 173:281–287

    Article  CAS  PubMed  Google Scholar 

  8. Gao Smith F, Perkins GD, Gates S, BALTI-2 Study Investigators et al (2012) Effect of intravenous b-2 agonist treatment on clinical outcomes in acute respiratory distress syndrome (BALTI-2): a multicentre, randomized controlled trial. Lancet 379:229–235

    Article  PubMed  Google Scholar 

  9. Matthay MA, Brower RG, Carson S, National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network et al (2011) Randomized, placebo-controlled clinical trial of an aerosolized β2-agonist for treatment of acute lung injury. Am J Respir Crit Care Med 184:561–568

    Article  CAS  PubMed  Google Scholar 

  10. Perkins GD, Gates S, Park D, Gao F et al; BALTI-Prevention Collaborators (2014) The beta agonist lung injury trial prevention: a randomized controlled trial. Am J Respir Crit Care Med 189:674–683

    Google Scholar 

  11. Johnson M (2006) Molecular mechanisms of beta (2)-adrenergic receptor function, response, and regulation. J Allergy Clin Immunol 117:18–24

    Article  CAS  PubMed  Google Scholar 

  12. Mutlu GM, Factor P (2008) Alveolar epithelial beta2-adrenergic receptors. Am J Respir Cell Mol Biol 38:127–134

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Bassford CR, Thickett DR, Perkins GD (2012) The rise and fall of β-agonists in the treatment of ARDS. Crit Care 16(2):208

    Article  PubMed Central  PubMed  Google Scholar 

  14. Berthiaume Y, Matthay MA (2007) Alveolar edema fluid clearance and acute lung injury. Respir Physiol Neurobiol 159:350–359

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Perkins GD, McAuley DF, Richter A et al (2004) Bench-to-bedside review: beta2-Agonists and the acute respiratory distress syndrome. Crit Care 8:25–32

    Article  PubMed Central  PubMed  Google Scholar 

  16. Perkins GD, Gao F, Thickett DR (2008) In vivo and in vitro effects of salbutamol on alveolar epithelial repair in acute lung injury. Thorax 63:215–220

    Article  CAS  PubMed  Google Scholar 

  17. Bloemen PG, van den Tweel MC, Henricks PA et al (1997) Increased cAMP levels in stimulated neutrophils inhibit their adhesion to human bronchial epithelial cells. Am J Physiol 272:580–587

    Google Scholar 

  18. Perkins GD, Nathani N, McAuley DF et al (2007) In vitro and in vivo effects of salbutamol on neutrophil function in acute lung injury. Thorax 62:36–42

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Tan KS, Nackley AG, Satterfield K et al (2007) Beta2 adrenergic receptor activation stimulates pro-inflammatory cytokine production in macrophages via PKA- and NF-kappaB-independent mechanisms. Cell Signal 19:251–260

    Article  CAS  PubMed  Google Scholar 

  20. Cazzola M, Page CP, Calzetta L, Matera MG (2012) Pharmacology and therapeutics of bronchodilators. Pharmacol Rev 64(3):450–504

    Article  CAS  PubMed  Google Scholar 

  21. Morgan DJ, Paull JD, Richmond BH et al (1986) Pharmacokinetics of intravenous and oral salbutamol and its sulphate conjugate. Br J Clin Pharmacol 22(5):587–593

    Article  PubMed Central  CAS  PubMed  Google Scholar 

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Correspondence to Vasileios Zochios MD .

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Zochios, V. (2015). Does β2-Agonist Use Improve Survival in Critically Ill Patients with Acute Respiratory Distress Syndrome?. In: Landoni, G., Mucchetti, M., Zangrillo, A., Bellomo, R. (eds) Reducing Mortality in Critically Ill Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-17515-7_13

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  • DOI: https://doi.org/10.1007/978-3-319-17515-7_13

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-17514-0

  • Online ISBN: 978-3-319-17515-7

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