News briefs from the journal CHEST, March 2005

March 07, 2005

Sodium Bicarbonate Can Help Treat Children With Life-Threatening Asthma

Sodium bicarbonate, commonly known as baking soda, may help treat children with life-threatening asthma (LTA), according to a new study. Researchers at Erasmus MC-Sophia Children's Hospital, Rottendam, the Netherlands, assessed the PICU medical records of all children with LTA who received IV sodium biocarbonate between January 1999 and November 2003. Under hospital protocol, children with LTA who had a pH of less than 7.15 and remained in respiratory distress following treatment with continuous nebulization, IV magnesium sulfate, and IV salbutamol, received sodium bicarbonate as part of their combination therapy to treat their acidosis, an above-normal increase in body fluids acidity, and to help b-agnoists have a stronger effect. Of the 17 children who received the sodium bicarbonate, 16 experienced an improvement in respiratory distress and level of consciousness. Other shown benefits of the treatment included a significant decrease in carbon dioxide level, a significant increase in pH, and in all but one case, a successful way to avoid mechanical ventilation. The study appears in the March issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

Anemia Common in Patients With COPD

In the first-ever study on anemia frequency and its pathophysiology in patients with chronic obstructive pulmonary disease (COPD), researchers from the University Hospital Charite, Berlin, Germany, and the National Heart and Lung Institute, Imperial College, London, UK, examined data from 101 patients with COPD (35 men and 66 women) and found that 13 patients (13%) had anemia. When researchers compared nine patients with anemia to nonanemic patients with COPD and normal control subjects, they found that patients with both anemia and COPD had increased inflammatory response and significantly elevated erythropoietin levels, a hormone which fosters red blood cell production by bone marrow. Further analysis revealed that subjects with anemia and COPD did not have decreased appetite and weight loss when compared to nonanemics, an indication that the development of anemia was independent of nutritional factors. Further research must be done to determine whether the health and prognosis of patients with COPD would benefit from erythropoietin and iron supplements. The study appears in the March issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

Classes of b-blockers Differ in Pulmonary Effects on Patients With COPD

Physicians and their patients with chronic obstructive pulmonary disease (COPD) should weigh expected cardiovascular benefits of b-blockers against possible adverse pulmonary effects, suggests a new study. Researchers from Groningen, the Netherlands, gave 15 patients with mild-to-moderate COPD and airway hyperresponsiveness (AHR) metoprolol, propranolol, celiprolol, or placebo for four days to determine the effects on lung function and AHR. Results showed that treatment with metoprolol and propranolol significantly lowered provocative concentration of methacholine, causing a 20% decrease in lung function when compared to celiprolol or placebo, and increased AHR. Propranolol was the only b-blocker class studied that deteriorated lung function and reduced the bronchodilating effect of formoterol. Furthermore, propanolol increased patients' sensitivity to environmental stimuli such as cold air and fog. Celiprolol appeared to be the safest option, as it did not alter lung function or AHR, nor did it affect bronchoconstriction negatively. The study appears in the March issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
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American College of Chest Physicians

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