A randomized trial of the effects of nebulized albuterol on pulmonary edema in brain-dead organ donors.
A randomized trial of the effects of nebulized albuterol on pulmonary edema in brain-dead organ donors.
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DOI：
10.1111/ajt.12564
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发表时间：
2014-03
期刊：
影响因子：
--
通讯作者：
California Transplant Donor Network
中科院分区：
文献类型：
--
作者：
Ware LB;Landeck M;Koyama T;Zhao Z;Singer J;Kern R;Neidlinger N;Nguyen J;Johnson E;Janz DR;Bernard GR;Lee JW;Matthay MA;California Transplant Donor Network
供体肺利用率持续较低，主要原因是供体肺功能障碍。我们假设，通过刺激肺泡液清除速度来增强肺水肿消退的治疗将改善供体氧合，增加供体肺的利用率。我们进行了一项随机、盲法、安慰剂对照试验，在506名器官捐赠者的主动供体管理期间，雾化沙丁胺醇(5 mg，q4h)与生理盐水安慰剂对照。主要结果是氧合(PaO2/FiO2)从登记到器官采购的变化。沙丁胺醇组(n=260)和安慰剂组(n=246)在年龄、性别、种族、吸烟和脑死亡原因方面匹配良好。从登记到购买器官，PaO2/FiO2的变化在治疗组之间没有差异(p=0.54)，供体肺利用也没有差异(沙丁胺醇29%对安慰剂32%，p=0.44)。与安慰剂组相比，沙丁胺醇组的捐献者更有可能减少(13%比1%，p<；0.001)或停止(8%比0%，p<；0.001)的研究药物剂量。综上所述，在供体管理期间使用大剂量沙丁胺醇吸入治疗不能改善供体氧合或增加供体肺利用率，但确实会引起心动过速。供者不宜使用大剂量沙丁胺醇雾化吸入以促进肺水肿的消退。
Donor lung utilization rates are persistently low primarily due to donor lung dysfunction. We hypothesized that a treatment that enhances the resolution of pulmonary edema by stimulating the rate of alveolar fluid clearance would improve donor oxygenation and increase donor lung utilization. We conducted a randomized, blinded, placebo-controlled trial of aerosolized albuterol (5 mg q4h) versus saline placebo during active donor management in 506 organ donors. The primary outcome was change in oxygenation (PaO2/FiO2) from enrollment to organ procurement. The albuterol (n=260) and placebo (n=246) groups were well matched for age, gender, ethnicity, smoking, and cause of brain death. The change in PaO2/FiO2 from enrollment to organ procurement did not differ between treatment groups (p=0.54) nor did donor lung utilization (albuterol 29% vs. placebo 32%, p=0.44). Donors in the albuterol vs. placebo group were more likely to have the study drug dose reduced (13% vs. 1%, p<0.001) or stopped (8% vs. 0%, p<0.001) for tachycardia. In summary, treatment with high dose inhaled albuterol during the donor management period did not improve donor oxygenation or increase donor lung utilization but did cause tachycardia. High dose aerosolized albuterol should not be used in donors to enhance the resolution of pulmonary edema.
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影响因子：
10
作者：
Perkins, G. D.;Nathani, N.;Thickett, D. R.
通讯作者：
Thickett, D. R.
影响因子：
8.8
作者：
Ojo, AO;Heinrichs, D;Metzger, RA
通讯作者：
Metzger, RA
影响因子：
3.3
作者：
Ware, LB;Fang, XH;Matthay, MA
通讯作者：
Matthay, MA
影响因子：
2.1
作者：
Ware, Lorraine B.;Neyrinck, Arne;Matthay, Michael A.
通讯作者：
Matthay, Michael A.
影响因子：
1.9
作者：
OBRIEN, PC;FLEMING, TR
通讯作者：
FLEMING, TR