Study design (if review, criteria of inclusion for studies)
Randomised 4-way cross-over design
Participants
n = 12 Males = 5 Females = 7. Mean age 29.9 years, range 16 years to 46 years (SD 9.4 years)
Interventions
Mannitol 300 mg (encapsulated dry powder) Pre-treated with terbutaline 1000 mcg (turbulhaler) HS 6% 7 ml IS (0.9%)+ matched voluntary cough Empty capsules with matched voluntary coughs All given as a single dose
Outcome measures
Sputum isotope % clearance at 30 minutes Sputum isotope clearance at 90 minutes* Mucociliary clearance*
Main results
Eight patients did not complete the study for diverse reasons. Fifteen of 17 patients taking placebo had decreased respiratory function status by the end of the study while 9 of 16 patients under piroxicam treatment retained their baseline values or improved their respiratory status. Piroxicam- treated patients required less hospitalization (192 d) than those receiving placebo (301 d).
Authors' conclusions
A long-term, large scale study would now be required to confirm the results of this preliminary investigation and to establish the significance of anti-inflammatory treatment with cyclooxgenase inhibitors to prevent lung tissue damage in patients with chronic obstructive pulmonary disease and Gram-negative pulmonary infection.