Respiratory care · 2026
Respiratory Mechanics After Inline Delivery of Tiotropium/Olodaterol During Mechanical Ventilation.
СтатьяНазвание и аннотация: Перевод в очереди
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Hsiao Hui-Yuan, Hung Shu-Yun, Lin Shoa-Lin, Huang Xiang-Hui, Cheng Ya-Chin
Аннотация
BACKGROUND: Administration of inhaled bronchodilators during mechanical ventilation is technically challenging, and data on the use of long-acting agents in this setting remain limited.
METHODS: In this prospective study, 23 hemodynamically stable COPD subjects receiving mechanical ventilation and considered ready for weaning were enrolled. Tiotropium/olodaterol (2.5/2.5 µg, 2 puffs) was delivered via an inline adapter. Outcomes included peak inspiratory pressure (PIP), plateau pressure (Pplat), mean airway pressure (P¯aw), respiratory system resistance (RRS), tidal volumes (VTi and VTe), and the SpO2/FIO2.
RESULTS: The median age was 76 years (interquartile range, 48-90), with 82.6% male subjects and 69.6% classified as GOLD stage 3 to 4. Compared with baseline, statistically significant changes occurred in PIP (P < .001), Pplat (P = .041), RRS (P = .004), and ventilator-measured VTi (P = .02) and VTe (P = .006). Variations in P¯aw (P = .067) and SpO2/FIO2 (P = .14) were not statistically significant. In exploratory subgroup analyses, greater changes in tidal volumes were observed in male subjects (VTi and VTe), subjects younger than 65 years (VTi), and those with a tracheostomy (VTe). No hemodynamic instability or treatment-related discontinuations were observed.
CONCLUSIONS: Inline delivery of tiotropium/olodaterol during mechanical ventilation was feasible and was associated with changes in respiratory mechanics in COPD subjects. Given the observational design and absence of a control group, these findings should be interpreted as physiologic observations rather than evidence of treatment efficacy.
METHODS: In this prospective study, 23 hemodynamically stable COPD subjects receiving mechanical ventilation and considered ready for weaning were enrolled. Tiotropium/olodaterol (2.5/2.5 µg, 2 puffs) was delivered via an inline adapter. Outcomes included peak inspiratory pressure (PIP), plateau pressure (Pplat), mean airway pressure (P¯aw), respiratory system resistance (RRS), tidal volumes (VTi and VTe), and the SpO2/FIO2.
RESULTS: The median age was 76 years (interquartile range, 48-90), with 82.6% male subjects and 69.6% classified as GOLD stage 3 to 4. Compared with baseline, statistically significant changes occurred in PIP (P < .001), Pplat (P = .041), RRS (P = .004), and ventilator-measured VTi (P = .02) and VTe (P = .006). Variations in P¯aw (P = .067) and SpO2/FIO2 (P = .14) were not statistically significant. In exploratory subgroup analyses, greater changes in tidal volumes were observed in male subjects (VTi and VTe), subjects younger than 65 years (VTi), and those with a tracheostomy (VTe). No hemodynamic instability or treatment-related discontinuations were observed.
CONCLUSIONS: Inline delivery of tiotropium/olodaterol during mechanical ventilation was feasible and was associated with changes in respiratory mechanics in COPD subjects. Given the observational design and absence of a control group, these findings should be interpreted as physiologic observations rather than evidence of treatment efficacy.