Respiratory Insufficiency in Postmenopausal Women: Materials and Methods

In: Respiratory

25 Aug 2014

Patient Selection
Fourteen postmenopausal women with permanent or previous episodic hypercapnic or hypoxemic respiratory failure were enrolled in the trial. The respiratory failure was caused by COPD, end-stage asthma, or late sequelae of pulmonary tuberculosis and assessed with daytime arterial blood gas measurements (Table 1). The criteria for postmenopausal status were age > 50 years, time since last menstruation at least 2 years, and serum concentrations of follicle-stimulating hormone (FSH) > 30 IU/L. Patients on estrogen were allowed to continue their hormone replacement therapy (Table 2).
The exclusion criteria were malignancies, heart diseases (except cor pulmonale), hepatic, renal, psychiatric, and neurologic diseases, thromboembolic events, unstable hypertension, severe rheumatoid arthritis, insulin-dependent diabetes, total serum cholesterol > 9.5 mmol/L, serum triglycerides > 2.5 mmol/L, use of any alternative medicine, medication with effects on the CNS, progestins except for MPA given by the research team, contraindications to MPA therapy, LTOT, current smoking, and current participation in any other clinical study. zyrtec tablets

The prestudy visit included measurements of blood hemoglobin concentration, hematocrit, WBC count, serum creatinine, alanine aminotransferase, total cholesterol, triglycerides, high-density lipoprotein, estradiol, progesterone, FSH, luteinizing hormone (LH), prolactin, sex hormone-binding globulin, and thyroid-stimulating hormone. Blood samples were collected between 7:00 am and 9:00 am after an overnight fast. The prestudy visit also included detailed taking of medical history and clinical examination. Written informed consent was obtained from all patients. The protocol was approved by the Joint Commission on Ethics of Turku University and Turku University Central Hospital, and National Agency for Medicines.
Table 1—Baseline Characteristics of Patients (N = 13)

Patient Characteristics Mean SD
Age, yr 67.0 6.30
Age at menopause, yr 49.2 4.71
Time since menopause, yr 17.2 9.45
Smoking, pack-yr 5.9 10.66
BMI, kg/m2 26.7 5.22
FEVj, L 0.78 0.34
FVC, L 1.23 0.44
FEVj, % 32 12.35
FVC, % 44 15.62
FEVj/FVC, % 64 14.17
Arterial pH 7.40 0.03
Paco2, mm Hg 42.8 4.88
Pao2, mm Hg 71.2 9.15
Systolic BP, mm Hg 155 20.81
Diastolic BP, mm Hg 78 14.71

Table 2—Baseline Characteristics of Patients

Patient Characteristics Patients (N = 13) %
COPD 9 69
Asthma 3 23
Late sequelae of pulmonary tuberculosis 4 31
dj-antitrypsin deficiency 2 15
Bronchiectasis 2 15
Tracheobronchial collapse 1 8
Pulmonary fibrosis 1 8
Suspected asbestosis 1 8
Past smokers 8 62
Current smokers 0 0
Current use of vaginal estrogen therapy 1 8

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