Supplementum 163 - Swiss Medical Weekly

35 S SWISS MED WKLY 2008;138(Suppl 163) · www.smw.ch
Poster Session 3 - SSP / SGP
P158
Aerosolised salbutamol accelerates the resolution
of pulmonary oedema after lung resection
J-M. Schnyder1 , J-M. Tschopp1 , J. Robert2 , J-G. Frey1 , J. Diaper2 ,
C. Ellenberger2 , M. Licker3 .
1 Centre Valaisan de Pneumologie (Crans-Montana, CH);
2 University Hospital of Geneva (Geneva, CH);
3 University of Geneva (Geneva, CH)
Background: Ischemia-reperfusion injuries, fluid overload and
cardiac insufficiency may all contribute to alveolar and interstitial lung
edema. We hypothesized that aerosolized salbutamol would reduce
extravascular lung water and improve oxygenation after lung
resection, by stimulating epithelial fluid clearance and cardiovascular
function.
Methods: This is a blinded, randomized, cross-over trial. We selected
twenty four patients with risk factors for lung edema (>60 yrs, history
of chronic alcohol consumption, prior radiation or chemotherapy,
cardiac insufficiency, coronary artery disease, recent pneumonia
and/or reduced diffusion capacity for carbon monoxide). Aerosolized
drugs (salbutamol 5 mg vs. ipratropium 0.5 mg) were given on 2
consecutive trials, with a 6-hours washout period, on the day of
surgery (POD 0) as well as on the first postoperative day (POD1).
Before and 50 min after the end of drug administration, we
determined the oxygenation index (PaO2/FIO2 ratio), the extravascular
lung water index (EVLWI), the pulmonary vascular permeability index
(PVPI) and the cardiac index (CI) using the single indicator thermal
dilution technique.
Results: Complete data were obtained in 21 patients. On POD0, the
EVLWI was increased compared with preoperative values (13.0 ± 3.8
vs. 9.1 ± 4.4, P