The safety of beta-blocker use in chronic obstructive pulmonary disease patients with respiratory failure in the intensive care unit
Tóm tắt
The safety of beta-blockers as a heart rate-limiting drug (HRLD) in patients with acute respiratory failure (ARF) due to chronic obstructive lung disease (COPD) has not been properly assessed in the intensive care unit (ICU) setting. This study aims to compare the use of beta-blocker drugs relative to non-beta-blocker ones in COPD patients with ARF due to heart rate-limiting with respect to length of ICU stay and mortality. We performed a retrospective (January 2011-December 2012) case-control study in a level III ICU in a teaching hospital. It was carried out in a closed ICU by the same intensivists. All COPD patients with ARF who were treated with beta-blockers (case group) and non-beta-blocker HRLDs (control group) were included. Their demographics, reason for HRLD, cause of ARF, comorbidities, ICU data including acute physiology and chronic health evaluation (APACHE II) score, type of ventilation, heart rate, and lengths of ICU and hospital stays were collected. The mortality rates in the ICU, the hospital, and over 30 days were also recorded. We enrolled 188 patients (46 female, n = 74 and n = 114 for the case and control groups, respectively). Reasons for HRLD (case and control group, respectively) were atrial fibrillation (AF, 23% and 50%), and supraventricular tachycardia (SVT, 41.9% and 54.4%). Patients’ characteristics, APACHE II score, heart rate, duration and type of ventilation, and median length of ICU-hospital stay were similar between the groups. The mortality outcomes in the ICU, hospital, and 30 days after discharge in the case and control groups were 17.6% versus 15.8% (p > 0.75); 18.9% versus 19.3% (p > 0.95) and 20% versus 11% (p > 0.47), respectively. Our results suggest that beta-blocker use for heart rate control in COPD patients with ARF is associated with similar ICU stay length and mortality compared with COPD patients treated with other HRLDs.
Tài liệu tham khảo
Falk JA, Kadiev S, Criner GJ, Scharf SM, Minai OA, Diaz P: Cardiac disease in chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2008, 5: 543-548. 10.1513/pats.200708-142ET.
Shibata Y, Watanabe T, Osaka D, Abe S, Inoue S, Tokairin Y, Igarashi A, Yamauchi K, Kimura T, Kishi H, Aida Y, Nunomiya K, Nemoto T, Sato M, Konta T, Kawata S, Kato T, Kayama T, Kubota I: Impairment of pulmonary function is an independent risk factor for atrial fibrillation: the Takahata study. Int J Med Sci. 2011, 8: 514-522.
Gunduz H, Talay F, Arinc H, Ozyildirim S, Akdemir R, Yolcu M, Kanat M, Uyan C: Heart rate variability and heart rate turbulence in patients with chronic obstructive pulmonary disease. Cardiol J. 2009, 16: 553-559.
Kushner FG, Hand M, Smith SC, King SB, Anderson JL, Antman EM, Bailey SR, Bates ER, Blankenship JC, Casey DE, Green LA, Hochman JS, Jacobs AK, Krumholz HM, Morrison DA, Ornato JP, Pearle DL, Peterson ED, Sloan MA, Whitlow PL, Williams DO: 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2009, 54: 2205-2241. 10.1016/j.jacc.2009.10.015.
Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, American College of Cardiology Foundation; American Heart Association: 2009 Focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration with the International Society for Heart and Lung Transplantation. J Am Coll Cardiol. 2009, 53: e1-e90. 10.1016/j.jacc.2008.11.013.
Andrikopoulos G, Pastromas S, Kartalis A, Toli K, Mantas I, Tzeis S, Kyrpizidis C, Olympios C, Manolis AJ, Foussas S, Kranidis A, Pras A, Pipilis A, Chryssos D, Gotsis A, Trikas A, Richter D, Alexopoulos D, Parthenakis F, Theodorakis G, Konstantinides S, Vardas P: Inadequate heart rate control isassociated with worse quality of life in patients with coronary artery disease and chronic obstructive pulmonary disease. The RYTHMOS study. Hellenic J Cardiol. 2012, 53: 118-126.
Global Initiative for Chronic Obstructive Lung Disease. Global strategy for diagnosis, management, and prevention of COPD [updated 2013].http://www.goldcopd.org,
Lammers JW, Folgering HT, van Herwaarden CL: Ventilatory effects of long-term treatment with pindolol and metoprolol in hypertensive patients with chronic obstructive lung disease. Br J Clin Pharmacol. 1985, 20: 205-210. 10.1111/j.1365-2125.1985.tb05062.x.
Van der Woude HJ, Zaagsma J, Postma DS, Winter TH, van Hulst M, Aalbers R: Detrimental effects of beta-blockers in COPD: a concern for nonselective beta-blockers. Chest. 2005, 127: 818-824. 10.1378/chest.127.3.818.
Salpeter S, Ormiston T, Salpeter E: Cardioselective beta-blockers for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2005, 4: CD003566-
Salpeter SR, Ormiston TM, Salpeter EE, Poole PJ, Cates CJ: Cardioselective beta-blockers for chronic obstructive pulmonary disease: a meta-analysis. Respir Med. 2003, 97: 1094-1101. 10.1016/S0954-6111(03)00168-9.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE: APACHE II: a severity of disease classification system. Crit Care Med. 1985, 13: 818-829. 10.1097/00003246-198510000-00009.
Nava S, Hill N: Non-invasive ventilation in acute respiratory failure. Lancet. 2009, 374: 250-259. 10.1016/S0140-6736(09)60496-7.
Ambrosino N, Vagheggini G: Noninvasive positive pressure ventilation in the acute care setting: where are we?. Eur Respir J. 2008, 31: 874-886. 10.1183/09031936.00143507.
Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, Cohen J, Opal SM, Vincent JL, Ramsay G: SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Intensive Care Med. 2001, 2003 (29): 530-538.
Spoelstra-de Man AME, Girbes ARJ: Comment on “Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008” by Dellinger et al. Intensive Care Med. 2008, 34: 1160-1162. 10.1007/s00134-008-1089-5.
Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, VanGelder IC, Al-Attar N, Hindricks G, Prendergast B, Heidbuchel H, Alfieri O, Angelini A, Atar D, Colonna P, De Caterina R, De Sutter J, Goette A, Gorenek B, Heldal M, Hohloser SH, Kolh P, Le Heuzey JY, Ponikowski P, Rutten FH, European Heart Rhythm Association: Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010, 31: 2369-2429.
Blomström-Lundqvist C, Scheinman MM, Aliot EM, Alpert JS, Calkins H, Camm AJ, Campbell WB, Haines DE, Kuck KH, Lerman BB, Miller DD, Shaeffer CW, Stevenson WG, Tomaselli GF, Antman EM, Smith SC, Alpert JS, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Hiratzka LF, Hunt SA, Jacobs AK, Russell RO, Priori SG, Blanc JJ, Budaj A, Burgos EF, Cowie M, Deckers JW, Garcia MA, Klein WW, Lekakis J, Lindahl B, Mazzotta G, Morais JC, Oto A, Smiseth O, Trappe HJ, European Society of Cardiology Committee, NASPE-Heart Rhythm Society: ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias--executive summary. a report of the American college of cardiology/American heart association task force on practice guidelines and the European society of cardiology committee for practice guidelines (writing committee to develop guidelines for the management of patients with supraventricular arrhythmias) developed in collaboration with NASPE-Heart Rhythm Society. J Am Coll Cardiol. 2003, 42: 1493-1531. 10.1016/j.jacc.2003.08.013.
Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJ, Ponikowski P, Poole-Wilson PA, Strömberg A, van Veldhuisen DJ, Atar D, Hoes AW, Keren A, Mebazaa A, Nieminen M, Priori SG, Swedberg K, ESC Committee for Practice Guidelines (CPG): ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur J Heart Fail. 2008, 10: 933-989. 10.1016/j.ejheart.2008.08.005.
Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L, Rynkiewicz A, Schmieder RE, StruijkerBoudier HA, Zanchetti A, Vahanian A, Camm J, De Caterina R, Dean V, Dickstein K, Filippatos G, Funck-Brentano C, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Kjeldsen SE, Erdine S, Narkiewicz K, Kiowski W, Agabiti-Rosei E, Ambrosioni E, Cifkova R, Dominiczak A, Fagard R, Heagerty AM, Laurent S, Lindholm LH, Mancia G, Manolis A, Nilsson PM, Redon J, Schmieder RE, Struijker-Boudier HA, Viigimaa M, Filippatos G, Adamopoulos S, Agabiti-Rosei E, Ambrosioni E, Bertomeu V, Clement D, Erdine S, Farsang C, Gaita D, Kiowski W, Lip G, Mallion JM, Manolis AJ, Nilsson PM, O'Brien E, Ponikowski P, Redon J, Ruschitzka F, Tamargo J, van Zwieten P, Viigimaa M, Waeber B, Williams B, Zamorano JL, The task force for the management of arterial hypertension of the European Society of Hypertension, The task force for the management of arterial hypertension of the European Society of Cardiology: Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2007, 2007 (28): 1462-1536.
Nava S, Karakurt S, Rampulla C, Braschi A, Fanfulla F: Salbutamol delivery during non-invasive mechanical ventilation in patients with chronic obstructive pulmonary disease: a randomized, controlled study. Intensive Care Med. 2001, 27: 1627-1635. 10.1007/s001340101062.
Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, Fukuchi Y, Jenkins C, Rodriguez-Roisin R, van Weel C, Zielinski J: Global initiative for chronic obstructive lung disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2007, 176: 532-555. 10.1164/rccm.200703-456SO.
Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O’Neal PV, Keane KA, Tesoro EP, Elswick RK: The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002, 166: 1338-1344. 10.1164/rccm.2107138.
Boles JM, Bion J, Connors A, Herridge M, Marsh B, Melot C, Pearl R, Silverman H, Stanchina M, Vieillard-Baron A, Welte T: Weaning from mechanical ventilation. Eur Respir J. 2007, 29: 1033-1056. 10.1183/09031936.00010206.
Cazzola M, Matera MG: Beta-blockers are safe in patients with chronic obstructive pulmonary disease, but only with caution. Am J Respir Crit Care Med. 2008, 178: 661-662. 10.1164/rccm.200806-963ED.
Callaerts-Vegh Z, Evans KL, Dudekula N, Cuba D, Knoll BJ, Callaerts PF, Giles H, Shardonofsky FR, Bond RA: Effects of acute and chronic administration of beta-adrenoceptor ligands on airway function in a murine model of asthma. Proc Natl Acad Sci U S A. 2004, 101: 4948-4953. 10.1073/pnas.0400452101.
Albouaini K, Andron M, Alahmar A, Egred M: Beta-blockers use in patients with chronic obstructive pulmonary disease and concomitant cardiovascular conditions. Int J Chron Obstruct Pulmon Dis. 2007, 2: 535-540. Review
Salpeter SR, Ormiston TM, Salpeter EE: Cardiovascular effects of beta-agonists in patients with asthma and COPD: a meta-analysis. Chest. 2004, 125: 2309-2321. 10.1378/chest.125.6.2309.
Soriano JB, Visick GT, Muellerova H, Payvandi N, Hansell AL: Patterns of comorbidities in newly diagnosed COPD and asthma in primary care. Chest. 2005, 128: 2099-2107. 10.1378/chest.128.4.2099.
Fabbri LM, Luppi F, Beghé B, Rabe KF: Complex chronic comorbidities of COPD. Eur Respir J. 2008, 31: 204-212. 10.1183/09031936.00114307.
Mainguy V, Girard D, Maltais F, Saey D, Milot J, Sénéchal M, Poirier P, Provencher S: Effect of bisoprolol on respiratory function and exercise capacity in chronic obstructive pulmonary disease. Am J Cardiol. 2012, 110: 258-263. 10.1016/j.amjcard.2012.03.019.
Hawkins NM, Jhund PS, Simpson CR, Petrie MC, Macdonald MR, Dunn FG, Macintyre K, McMurray JJ: Primary care burden and treatment of patients with heart failure and chronic obstructive pulmonary disease in Scotland. Eur J Heart Fail. 2010, 12: 17-24. 10.1093/eurjhf/hfp160.
Jabbour A, Macdonald PS, Keogh AM, Kotlyar E, Mellemkjaer S, Coleman CF, Elsik M, Krum H, Hayward CS: Differences between beta-blockers in patients with chronic heart failure and chronic obstructive pulmonary disease: a randomized crossover trial. J Am Coll Cardiol. 2010, 55: 1780-1787. 10.1016/j.jacc.2010.01.024.
Dransfield MT, Rowe SM, Johnson JE, Bailey WC, Gerald LB: Use of beta blockers and the risk of death in hospitalised patients with acute exacerbations of COPD. Thorax. 2008, 63: 301-305. 10.1136/thx.2007.081893.
Brooks TW, Creekmore FM, Young DC, Asche CV, Oberg B, Samuelson WM: Rates of hospitalizations and emergency department visits in patients with asthma and chronic obstructive pulmonary disease taking beta-blockers. Pharmacotherapy. 2007, 27: 684-690. 10.1592/phco.27.5.684.
Stefan MS, Rothberg MB, Priya A, Pekow PS, Au DH, Lindenauer PK: Association between β-blocker therapy and outcomes in patients hospitalised with acute exacerbations of chronic obstructive lung disease with underlying ischaemic heart disease, heart failure or hypertension. Thorax. 2012, 67: 977-984. 10.1136/thoraxjnl-2012-201945.
Confalonieri M, Garuti G, Cattaruzza MS, Osborn JF, Antonelli M, Conti G, Kodric M, Resta O, Marchese S, Gregoretti C, Rossi A, Italian noninvasive positive pressure ventilation (NPPV) study group: A chart of failure risk for noninvasive ventilation in patients with COPD exacerbation. Eur Respir J. 2005, 25: 348-355. 10.1183/09031936.05.00085304.
Alaithan AM, Memon JI, Rehmani RS, Qureshi AA, Salam A: Chronic obstructive pulmonary disease: hospital and intensive care unit outcomes in the Kingdom of Saudi Arabia. Int J Chron Obstruct Pulmon Dis. 2012, 7: 819-823.