Cardiovascular and pulmonary effects of aerosolized prostacyclin administration in severe respiratory failure using a ventilator nebulization system

Bein, Thomas and Metz, Christoph and Keyl, Cornelius and Sendtner, Ernst and Pfeifer, Michael (1996) Cardiovascular and pulmonary effects of aerosolized prostacyclin administration in severe respiratory failure using a ventilator nebulization system. JOURNAL OF CARDIOVASCULAR PHARMACOLOGY, 27 (4). pp. 583-586. ISSN 0160-2446,

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Abstract

We investigated the effects of aerosolized prostacyclin (PGI(2)) administration on hemodynamics and pulmonary gas exchange in 8 patients with severe respiratory failure and acute pulmonary hypertension. Nebulization of epoprostenol (5 ng/kg body weight for 15 min) decreased mean pulmonary blood pressure from 41.2 +/- 6.7 mm Hg (mean +/- SD, before administration) to 36.1 +/- 6 mm Hg less than or equal to 15 min (p < 0.05). The effect was reversed 10 min after discontinuation of PGI(2) (40.9 +/- 6.3 mm Hg). Pulmonary vascular resistance index (339 +/- 138 dynes . s . cm(-5) . m(2), before administration) was significantly (p < 0.05) reduced less than or equal to 15 min (260 +/- 89 dynes . s . cm(-5) . m(2)) and increased again after discontinuation of PGI(2) (341 +/- 142 dynes . s . cm(-5) . m(2)). The ratio of arterial oxygen to the fraction of inspired oxygen (PaO2/FiO(2)) increased from 119 +/- 34 mm Hg (before administration) to 163 +/- 76 mm Hg (15 min after initiation of administration p < 0.05) and was reduced after PGI(2) discontinuation (116 +/- 35 mm Hg). Heart rate, mean blood pressure, central venous pressure, and pulmonary arterial wedge pressure remained unchanged, whereas cardiac index was slightly reduced. We assume that PGI(2) aerosolization is a beneficial technique, applied with a ventilator nebulization system. The beneficial effect might be caused by selective pulmonary vasodilatation in well-ventilated areas of the lung.

Item Type: Article
Uncontrolled Keywords: DISTRESS-SYNDROME; NITRIC-OXIDE; HYPERTENSION; respiratory failure; acute pulmonary hypertension; prostacyclin; aerosolization
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Anästhesiologie
Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie
Medicine > Lehrstuhl für Innere Medizin II
Depositing User: Dr. Gernot Deinzer
Date Deposited: 02 Nov 2023 07:23
Last Modified: 02 Nov 2023 07:23
URI: https://pred.uni-regensburg.de/id/eprint/51835

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