The feudal structure of global health and its implications for decolonisation

Bibliographic Data

ID21880686
AuthorsVikash Ranjan Keshri (0000-0001-6668-0107, UNSW Sydney, corresponding author), Soumyadeep Bhaumik (0000-0001-9579-4453, UNSW Sydney, corresponding author)
Year2022
Volume7
Issue9
Pagese010603
Publication date2022-09-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2022-010603
PMID36167407
OpenAlexW4297321253
LanguageEN
Citations received10
References cited14

The degree of acute improvement in spirometric indices after bronchodilator inhalation varies among chronic obstructive pulmonary disease (COPD) patients, and depends upon the type and dose of bronchodilator and the timing of administration. Acute bronchodilator responsiveness at baseline was examined in a large cohort of patients with moderate-to-very-severe COPD participating in the Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT) trial, a 4-yr randomised double-blind trial evaluating the efficacy of 18 μg tiotropium daily in reducing the rate of decline in lung function. After wash-out of respiratory medications, patients received 80 μg ipratropium followed by 400 μg salbutamol. Spirometry was performed before and 90 min following ipratropium administration. The criteria used for forced expiratory volume in one second (FEV 1 ) responsiveness were: ≥12% increase over baseline and ≥200 mL; ≥15% increase over baseline; and ≥10% absolute increase in the percentage predicted value. Of the patients, 5,756 had data meeting the criteria for analysis (age 64.5 yrs; 75% male; baseline FEV 1 1.10 L (39.3% predicted) and forced vital capacity (FVC) 2.63 L). Compared with baseline, mean improvements were 229 mL in FEV 1 and 407 mL in FVC. Of these patients, 53.9% had ≥12% and ≥200 mL improvement in FEV 1 , 65.6% had ≥15% improvement in FEV 1 , and 38.6% had ≥10% absolute increase in FEV 1 % pred. The majority of patients with moderate-to-very-severe chronic obstructive pulmonary disease demonstrate meaningful increases in lung function following administration of inhaled anticholinergic plus sympathomimetic bronchodilators

Anesthesia · Asthma · Bronchodilator · COPD · Diffusing capacity · Ipratropium · Lung · Lung function · Pulmonary function testing · Salbutamol · Spirometry · Vital capacity · Asthma and respiratory diseases · Chronic Obstructive Pulmonary Disease (COPD) Research · Family and Patient Care in Intensive Care Units · Medicine · Internal Medicine