-- Robert Preidt
SUNDAY, Dec. 11 (HealthDay News) -- A study assessing
intravenous infusion of the drug salbutamol in patients with acute
respiratory distress syndrome was halted because the treatment did
not improve patient outcomes and was associated with an increased
risk of death, researchers say.
Acute respiratory distress syndrome (ARDS) occurs in about 14
percent of patients who require being placed on mechanical
ventilation. The death rate among patients with ARDS is high -- 40
to 60 percent -- and survivors have a substantial decrease in their
quality of life.
However, "routine use of [beta-2] agonist therapy in
mechanically ventilated patients with ARDS cannot be recommended,"
the researchers wrote in an article published in the Dec. 12 online
The British study included 326 patients who received either
salbutamol (also known as albuterol) or a placebo within 72 hours
of developing ARDS, and the treatment continued for up to seven
days. But the study was stopped after 55 (34 percent) of the 161
patients in the salbutamol group died, compared with 38 (23
percent) of the 163 patients in the placebo group.
Overall, the death rate was 47 percent higher in the salbutamol
group than in the placebo group, the report indicated.
In addition, patients in the salbutamol group had fewer
ventilator-free days and organ failure-free days than those in the
"Our findings show that intravenous salbutamol given to patients with early ARDS significantly increased 28-day mortality, and reduced ventilator-free days and duration of organ support compared with those given placebo," Fang Gao Smith and Gavin Perkins of the University of Warwick, and colleagues, explained in a journal news release.
The authors added that the therapy was "poorly tolerated" by
patients because it was linked to heart rhythm abnormalities and
lactic acidosis (a dangerous buildup of lactic acid in the blood).
"These findings were unexpected," the researchers noted.
The findings of the cancelled study may be sufficient to change
treatment of patients with ARDS, Dr. B. Taylor Thompson, of
Massachusetts General Hospital and Harvard Medical School, wrote in
an accompanying editorial.
"[Beta-2] agonist treatment in patients with ARDS should be limited to the treatment of clinically important reversible airway obstruction and should not be part of routine care," Thompson recommended.
The U.S. National Heart, Lung, and Blood Institute has more
acute respiratory distress syndrome.
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