Inhaled prostacyclin (PGI2) versus inhaled nitric oxide in adult respiratory distress syndrome

American Journal of Respiratory and Critical Care Medicine
B ZwisslerK Peter

Abstract

Inhalation of nitric oxide (NO) and prostacyclin (PGI2) may induce selective pulmonary vasodilation and-by improving ventilation-perfusion ratio in ventilated areas of the lung-increase Pao2 in patients with acute lung injury. To assess the therapeutic efficacy of both compounds, dose-response curves were established in patients with adult respiratory distress syndrome (ARDS). Patients received both PGI2 (doses of 1, 10, and 25 ng/kg/min) and NO (concentrations of 1, 4, and 8 ppm). Cardiorespiratory parameters were assessed at control, at each drug concentration, and after withdrawal of NO and PGI2. PGI2 resulted in a significant, dose-dependent and selective reduction of pulmonary artery pressure (PAP) from 35.1 +/- 6.3 mm Hg at control to 33.1 +/- 4.8 (1 ng/kg/min), 31.3 +/- 4.8 mm Hg (10 ng/kg/min) and 29.6 +/- 4.5 mm Hg (25 ng/kg/min), respectively. Inhaled NO reduced PAP from 34.5 +/- 5.6 to 32.1 +/- 5.9 mm Hg at 4 ppm, and to 31.8 +/- 6.1 mm Hg at 8 ppm, respectively, with no effect at 1 ppm. Pao2/Flo2 ratio increased from 105 +/- 37 to 125 +/- 56 mm Hg (range of increase: 0 to 57 mm Hg) at PGI2 10 ng/kg/min and to 131 +/- 63 mm Hg (range: -5 to 89 mm Hg) at 25 ng/kg/min with no effect at 1 ng/kg/min. NO improved Pao2 (e....Continue Reading

Citations

Jan 29, 2011·European Journal of Applied Physiology·Lars L KarlssonJohan Petersson
May 16, 1998·The Annals of Thoracic Surgery·C S RayhrerJ S Young
Feb 13, 2001·Resuscitation·P A OakleyP J Morrison
Oct 26, 2002·Free Radical Biology & Medicine·Daniela Salvemini, Salvatore Cuzzocrea
Jan 23, 1999·The New England Journal of Medicine·A P Wheeler, G R Bernard
Aug 2, 2002·The New England Journal of Medicine·Horst OlschewskiUNKNOWN Aerosolized Iloprost Randomized Study Group
Dec 24, 2005·The New England Journal of Medicine·Mark J D Griffiths, Timothy W Evans
Jul 17, 2003·The American Journal of Nursing·Paula Lusardi, Virginia Brown
Oct 16, 1999·Anesthesiology·W SteudelW M Zapol
Aug 10, 2002·Anesthesiology·Stuart M Lowson
Oct 3, 2006·Current Opinion in Anaesthesiology·J BriegelM Haller
Oct 3, 2006·Current Opinion in Anaesthesiology·M Leeman, J L Vincent
Oct 3, 2006·Current Opinion in Anaesthesiology·J Meyer, M Booke
May 12, 2000·Critical Care Medicine·E M Bulger, R V Maier
Sep 29, 2000·Critical Care Medicine·R C McIntyreE Abraham
Mar 30, 2005·International Anesthesiology Clinics·John G Augoustides, E Andrew Ochroch
Apr 12, 2003·Critical Care Medicine·Udo KaisersKonrad J Falke
Apr 9, 2004·Critical Care Medicine·Jennifer L Turi, Ira M Cheifetz
Mar 9, 2005·Critical Care Medicine·Stuart M Lowson
Dec 13, 2005·Critical Care Medicine·James A Cook
Mar 17, 2006·Critical Care Medicine·Thomas BeinHans J Schlitt
Oct 30, 2004·The Journal of Trauma·Yoram KleinErik S Barquist
Feb 22, 2011·Critical Care Medicine·Allan J Walkey, Renda Soylemez Wiener
Jan 2, 2007·Current Opinion in Critical Care·Rajiv Dhand
Jan 31, 2009·Current Opinion in Critical Care·Bryce R H RobinsonRichard D Branson
Dec 3, 2009·Current Opinion in Critical Care·Angela J Frank, B Taylor Thompson
Dec 4, 2012·Current Opinion in Critical Care·Gregory A Schmidt
Feb 5, 2000·BMJ : British Medical Journal·S Stott
May 29, 1998·American Journal of Respiratory and Critical Care Medicine·J R MichaelR W Day
Jan 5, 1999·American Journal of Respiratory and Critical Care Medicine·F HinderJ Meyer
Aug 3, 1999·American Journal of Respiratory and Critical Care Medicine·H OlschewskiW Seeger
Jun 18, 2011·American Journal of Respiratory and Critical Care Medicine·Alvar Agustí, Jørgen Vestbo
May 5, 2006·Journal of Intensive Care Medicine·Magda Cepkova, Michael A Matthay
May 16, 2013·Critical Care : the Official Journal of the Critical Care Forum·Jonathan A Silversides, Niall D Ferguson
Sep 23, 2010·Critical Care : the Official Journal of the Critical Care Forum·Laura C PriceStephen J Brett
Apr 12, 2001·Critical Care : the Official Journal of the Critical Care Forum·R Naeije, S Brimioulle

❮ Previous
Next ❯

Related Concepts

Related Feeds

American Thoracic Association Journals

Discover the latest respiratory research published by the journals from the American Thoracic Society.