Azerbaijani
Albanian
Arabic
Armenian
Azerbaijani
Belarusian
Bengali
Bosnian
Catalan
Czech
Danish
Deutsch
Dutch
English
Estonian
Finnish
Français
Greek
Haitian Creole
Hebrew
Hindi
Hungarian
Icelandic
Indonesian
Irish
Italian
Japanese
Korean
Latvian
Lithuanian
Macedonian
Mongolian
Norwegian
Persian
Polish
Portuguese
Romanian
Russian
Serbian
Slovak
Slovenian
Spanish
Swahili
Swedish
Turkish
Ukrainian
Vietnamese
Български
中文(简体)
中文(繁體)

Albuterol to Improve Respiratory Strength in SCI

Yalnız qeydiyyatdan keçmiş istifadəçilər məqalələri tərcümə edə bilərlər
Giriş / Qeydiyyatdan keçin
Bağlantı panoya saxlanılır
StatusAktiv, işə qəbul deyil
Sponsorlar
VA Office of Research and Development

Açar sözlər

Mücərrəd

Spinal cord injury (SCI), especially involving the cervical and upper thoracic segments, can significantly compromise respiratory muscle function. Respiratory complications can ensue, including lung collapse and pneumonia, which are the primary cause for mortality in association with traumatic SCI both during the acute and chronic phases post-injury. Lesions at the level of the cervical or high thoracic spinal cord result in respiratory muscle weakness, which is associated with ineffective cough, mucus retention, and mucus plugging. Despite the fact that pulmonary complications are a major cause of morbidity and mortality in this population, there is a paucity of effective interventions in the SCI population known to improve respiratory muscle strength with pharmacologic interventions receiving little to no attention. The current objective of this study is to determine the effectiveness of 16 weeks of sustained release oral Albuterol to; (1) improve respiratory muscular strength, and (2) improve cough effectiveness.

Təsvir

Although the past 40 years has witnessed a substantial improvement in the acute and chronic management of persons with SCI, mortality remains high during the first year post-injury, and pulmonary complications including pneumonia, lung collapse (atelectasis), respiratory failure, and thromboembolism are the predominant cause. The propensity for pulmonary complications among subjects with SCI stems from paralysis of respiratory muscles. Injury to the cervical and upper thoracic cord significantly compromises function of the diaphragm, intercostal muscles, accessory respiratory muscles, and abdominal muscles. Respiratory muscle dysfunction is manifest as diminution in lung volumes, reduction in maximal static inspiratory and expiratory mouth pressures (MIP and MEP, respectively), and reduction in peak cough pressure and flow. Cough effectiveness is contingent upon both inspiratory and expiratory muscle strength; increasing the pressure-generating capacity of the inspiratory and expiratory muscles in persons with tetraplegia and high paraplegia may, therefore, translate to improved cough effectiveness and reduction in the propensity for atelectasis and, possibly, pneumonia.

Respiratory muscle training, often utilizing simple hand-held portable resistive or threshold training devices, appears to have marginal effects on vital capacity and maximal static mouth inspiratory and expiratory pressures (MIP and MEP, respectively), although data is inconclusive. Pharmacologic interventions to improve respiratory muscle strength have received little attention in the SCI population. Studies involving oral beta-2 adrenergic agonists, which have been shown to elicit anabolic effects on skeletal muscle in young men and an increase in muscle strength among patients with facioscapulohumeral muscular dystrophy, have also demonstrated salutary effects in persons with SCI. There are many foreseeable advantages of a pharmacologic approach to improve respiratory muscle strength in persons with SCI. For instance, RMT can be physically demanding and time consuming, compliance can be an issue, and sustainable improvements have not been realized. The intent in the present proposal is to enroll a targeted cohort of 24 comparatively weaker subjects with tetraplegia and high paraplegia in a randomized, double-blind, placebo-controlled, parallel group trial to assess the effects of an oral beta-2 agonist upon respiratory muscle strength and cough effectiveness.

Tarixlər

Son Doğrulandı: 05/31/2020
İlk təqdim: 07/14/2015
Təxmini qeydiyyat təqdim edildi: 07/21/2015
İlk Göndərmə: 07/23/2015
Son Yeniləmə Göndərildi: 06/21/2020
Son Yeniləmə Göndərildi: 06/24/2020
Həqiqi Təhsilin Başlama Tarixi: 05/31/2016
Təxmini İlkin Tamamlanma Tarixi: 03/01/2022
Təxmini İşin Tamamlanma Tarixi: 06/01/2024

Vəziyyət və ya xəstəlik

Spinal Cord Injury
Respiratory Muscle Weakness

Müdaxilə / müalicə

Drug: Active Oral Beta-2

Drug: Placebo

Faza

Faza 4

Qol Qrupları

QolMüdaxilə / müalicə
Active Comparator: Active Oral Beta-2
Subjects will receive 16 weeks of active medication.
Drug: Active Oral Beta-2
Subjects will receive extended release Albuterol, 4mg twice daily for the first week. The remaining 15 weeks subjects will receive extended release Albuterol, 8mg twice daily.
Placebo Comparator: Placebo
Subjects will receive 16 weeks of placebo medication.
Drug: Placebo
Subjects will receive placebo tablets twice daily for 16 weeks.

Uyğunluq Kriteriyaları

Təhsil üçün uyğun yaşlar 18 Years Üçün 18 Years
Təhsilə Uyğun CinslərAll
Sağlam Könüllüləri qəbul edirBəli
Kriteriyalar

Inclusion Criteria:

- Male or Female age 18 to 80

- Chronic spinal cord injury ( 1 year since injury)

- Neurological level of injury between C3-C8 (Tetraplegia)

- Neurological level of injury between T1-T6 (High Paraplegia)

- Males with maximal inspiratory pressure (MIP) < 90 cmH2O or

- Females with maximal inspiratory pressure (MIP) < 65 cmH2O

Exclusion Criteria:

- Smoking, active or history of smoking with the past year

- Ventilator Dependence

- History of blast injuries to the chest

- Antidepressant use

- History of asthma

- Active respiratory disease or recent(within 3 months) respiratory infections

- Uncontrolled hypertension or cardiovascular disease

- Current use a beta-2 adrenergic agonists

- History of epilepsy or seizure disorder

- Hyperthyroidism

- Currently taking corticosteroids

- Currently taking monoamine oxidase inhibitors or tricyclic antidepressants

- Hypersensitivity to albuterol or any of its' constituents

- Pregnant

- Use or are suspected of using over-the counter supplements or prescribed medications with anabolic characteristics (promotes improvements to muscle mass and strength) including, but not limited to:

- creatine monohydrate

- anabolic steroids (e.g., testosterone)

- growth hormone

- substances with similar actions or indications as those listed

Nəticə

İlkin nəticə tədbirləri

1. Change in Respiratory Muscle Strength [Baseline, Week 16, Week 18]

Respiratory muscle strength will be determined by maximal inspiratory pressure and maximal expiratory pressure at the mouth during baseline visit, week 16 visit and week 18 visit.

Facebook səhifəmizə qoşulun

Elm tərəfindən dəstəklənən ən tam dərman bitkiləri bazası

  • 55 dildə işləyir
  • Elm tərəfindən dəstəklənən bitki mənşəli müalicələr
  • Təsvirə görə otların tanınması
  • İnteraktiv GPS xəritəsi - yerdəki otları etiketləyin (tezliklə)
  • Axtarışınızla əlaqəli elmi nəşrləri oxuyun
  • Təsirlərinə görə dərman bitkilərini axtarın
  • Maraqlarınızı təşkil edin və xəbər araşdırmaları, klinik sınaqlar və patentlər barədə məlumatlı olun

Bir simptom və ya bir xəstəlik yazın və kömək edə biləcək otlar haqqında oxuyun, bir ot yazın və istifadə olunan xəstəliklərə və simptomlara baxın.
* Bütün məlumatlar dərc olunmuş elmi araşdırmalara əsaslanır

Google Play badgeApp Store badge