ESMOLOL AND VENTILATORY FUNCTION IN CARDIAC PATIENTS WITH COPD

To assess the effects of acute cardioselective beta blockade on ventilatory function in patients with COPD and active cardiac disorders, 50 patients were studied during intravenous infusion of esmolol. All patients had an obstructive ventilatory component on baseline pulmonary function testing, and 58 percent had a significant bronchodilator response to inhaled albuterol. Esmolol infusion (8 to 24 mg/ min) produced large decreases in heart rate (84 +/- 2 to 69 +/- 2 beats/min, p < 0.01) and SBP (124 +/- 3 to 106 +/- 3 mm Hg, p < 0.01). Despite this marked hemodynamic response, there was no significant group effect of beta blockade on pulmonary function. No patient experienced dyspnea or wheezing with acute esmolol infusion; however, three patients (6 percent) developed asymptomatic decreases of FEV1. It is concluded that acute beta blockade with esmolol can be achieved in patients with COPD and cardiac disorders with little risk of bronchospasm.