2012
DOI: 10.1016/s0140-6736(11)61845-x
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β-agonists for ARDS: the dark side of adrenergic stimulation?

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Cited by 9 publications
(5 citation statements)
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“…As discussed previously, the findings from the BALTI-2 study are alarming and indicate the need for further research in the air medical use of salbutamol tocolysis in women with TPTL and cardiovascular disease. 21 In our study, the incidence of metabolic changes secondary to salbutamol was scarce. Two cases demonstrated women who suffered hypokalaemia requiring supplementation, and a further 2 were diagnosed with hyperglycaemia.…”
Section: Discussionmentioning
confidence: 56%
See 1 more Smart Citation
“…As discussed previously, the findings from the BALTI-2 study are alarming and indicate the need for further research in the air medical use of salbutamol tocolysis in women with TPTL and cardiovascular disease. 21 In our study, the incidence of metabolic changes secondary to salbutamol was scarce. Two cases demonstrated women who suffered hypokalaemia requiring supplementation, and a further 2 were diagnosed with hyperglycaemia.…”
Section: Discussionmentioning
confidence: 56%
“…20 Despite no available research on salbutamol use with women who suffer from heart disease who are in TPTL, 1 study (the BALTI-2 [Beta-Agonist Lung Injury Trial-2] study) demonstrated beta-agonist use in critical illness can potentially exacerbate myocardial injury and cardiac failure. 21 The study was ceased midtrial in the treatment of acute respiratory distress syndrome with a 7-day continuous infusion of salbutamol due to a significant rise in mortality. This is as close as a comparison available for beta-agonist use in the emergency retrieval setting where infusions last from 30 minutes up to 12 hours on average in WA.…”
Section: Discussionmentioning
confidence: 99%
“…The alveolar epithelial cell injury is one of the initial steps of ARDS development (Thompson et al, 2017), leading to decreased AFC and alveolar edema. The restoration of alveolar epithelial function is closely associated with the resolution of pulmonary edema and better clinical outcomes (Ware and Matthay, 2001).…”
Section: Keratinocyte Growth Factormentioning
confidence: 99%
“…The inconsistency between basic study and clinical practice may be explained by several underlying mechanisms: 1) epithelial injury during ARDS can limit the interaction between β-agonists and its receptor, whereas continuous administration of β-agonists downregulates the expression of receptors, thus leading to unresponsiveness; 2) β-agonists have a positive inotropic effect on the myocardium, increasing cardiac output and exacerbating alveolar-capillary leakage; and 3) β-agonists could stimulate the RAAS, which could hinder the effect of AFC ( Thompson, 2012 ). Because it lacks the benefit and suggests the tendency to cause harm, such as arrhythmia and tachycardia, β-agonists may not be considered a routine solution.…”
Section: Conventional Drugs For the Treatment Of Ardsmentioning
confidence: 99%
“…In the Lancet editorial on the subject, 8 it was recommended that 'For now, the results of the truncated BALTI-2 trial are indeed sufficient to change practice. β2-agonist therapy in patients with ARDS should be limited to the treatment of clinically important reversible airways obstruction and should not be part of routine care.…”
Section: Evidence For Changementioning
confidence: 99%