We studied the effects of theophylline on diaphragmatic strength and fatigue in 15 patients with severe chronic obstructive pulmonary disease. Diaphragmatic strength was assessed by measurement of the transdiaphragmatic pressure generated at functional residual capacity during a maximal inspiratory effort against closed airways. Diaphragmatic fatigue was induced by resistive loaded breathing. The electrical activity of the diaphragm was recorded with an esophageal electrode during the fatigue runs, and the high-low ratio of the electrical signal was analyzed to assess diaphragmatic fatigue. Studies were performed before and after 7 and 30 days of theophylline administration (mean plasma level, 13 +/- 2 mg per liter). A control group received a placebo instead of theophylline. Theophylline increased maximal transdiaphragmatic pressure by 16 per cent after 7 days of administration (P less than 0.01), and this increase persisted after 30 days. No significant change in maximal transdiaphragmatic pressure was observed in the group given the placebo. Theophylline also suppressed diaphragmatic fatigue in all patients who received it. We conclude that theophylline has a potent and long-lasting effect on diaphragmatic strength and fatigue in patients with fixed airway obstruction.
This article has been cited by other articles:
Rabe, K. F., Hurd, S., Anzueto, A., Barnes, P. J., Buist, S. A., Calverley, P., Fukuchi, Y., Jenkins, C., Rodriguez-Roisin, R., van Weel, C., Zielinski, J.
(2007). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: GOLD Executive Summary. Am. J. Respir. Crit. Care Med.
176: 532-555
[Abstract][Full Text]
Bascom, A. T., Lattin, C. D., Aboussouan, L. S., Goshgarian, H. G.
(2005). Effect of Acute Aminophylline Administration on Diaphragm Function in High Cervical Tetraplegia: A Case Report. Chest
127: 658-661
[Abstract][Full Text]
MacNee, W, Calverley, P M A
(2003). Chronic obstructive pulmonary disease * 7: Management of COPD. Thorax
58: 261-265
[Abstract][Full Text]
Culpitt, S. V., de Matos, C., Russell, R. E., Donnelly, L. E., Rogers, D. F., Barnes, P. J.
(2002). Effect of Theophylline on Induced Sputum Inflammatory Indices and Neutrophil Chemotaxis in Chronic Obstructive Pulmonary Disease. Am. J. Respir. Crit. Care Med.
165: 1371-1376
[Abstract][Full Text]
ZuWallack, R. L., Mahler, D. A., Reilly, D., Church, N., Emmett, A., Rickard, K., Knobil, K.
(2001). Salmeterol Plus Theophylline Combination Therapy in the Treatment of COPD. Chest
119: 1661-1670
[Abstract][Full Text]
Ream, R. S., Loftis, L. L., Albers, G. M., Becker, B. A., Lynch, R. E., Mink, R. B.
(2001). Efficacy of IV Theophylline in Children With Severe Status Asthmaticus. Chest
119: 1480-1488
[Abstract][Full Text]
PAUWELS, R. A., BUIST, A. S., CALVERLEY, P. M. A., JENKINS, C. R., HURD, S. S.
(2001). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease . NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop Summary. Am. J. Respir. Crit. Care Med.
163: 1256-1276
[Full Text]
McNicholas, W. T.
(2000). Impact of Sleep in COPD. Chest
117: 48S-53S
[Abstract][Full Text]
Ferguson, G. T., Khanchandani, N., Lattin, C. D., Goshgarian, H. G.
(1999). Clinical Effects of Theophylline on Inspiratory Muscle Drive in Tetraplegia. Neurorehabil Neural Repair
13: 191-197
[Abstract]
Price, J. A., Rizk, N. W.
(1999). Postoperative Ventilatory Management. Chest
115: 130S-137S
[Abstract][Full Text]
Zeppetella, G.
(1998). The palliation of dyspnea in terminal disease. AM J HOSP PALLIAT CARE
15: 322-330
[Abstract]
Nakura, H., Tateishi, T., Watanabe, M., Asoh, M., Tanaka, M., Kumai, T., Kobayashi, S.
(1998). Effect of Hypoalbuminemia on the Disposition of Theophylline. Comparative Study with Sprague-Dawley Rats and a Mutant Sprague-Dawley Hyperlipidemic Strain with Hypoalbuminemia. Drug Metab. Dispos.
26: 595-597
[Abstract][Full Text]
Weinberger, M., Hendeles, L.
(1996). Theophylline in Asthma. NEJM
334: 1380-1388
[Full Text]
de Conno, F., Spoldi, E., Caraceni, A., Ventafridda, V.
(1991). Does pharmacological treatment affect the sensation of breathlessness in terminal cancer patients?. Palliat Med
5: 237-243
[Abstract]
