The effects of intravenous almitrine on oxygenation and hemodynamics during one-lung ventilation

Anesthesia and Analgesia
Marc MoutafisMarc Fischler

Abstract

One-lung ventilation (OLV) induces an increase in pulmonary shunt sometimes associated with a decrease in PaO2 despite ventilation with 100% oxygen. PaO2 improvement has been reported in one-lung ventilated animals receiving IV almitrine, a pulmonary vasoconstrictor. We evaluated the ability of almitrine to prevent a decrease in PaO2 during OLV. Patients without pulmonary hypertension undergoing OLV for lung surgery were randomly assigned to receive either placebo (Group P, n = 8) or almitrine infusion at a rate of 8 microg x kg(-1) x min(-1) (Group A, n = 8) from the start of OLV. Gasometric and hemodynamic values were recorded with the patient in the lateral decubitus position during two-lung ventilation and at 10-min intervals during OLV over a 30-min period (OLV-10, OLV-20, OLV-30). Compared with the values found during two-lung ventilation (434 +/- 22 mm Hg in Group P and 426 +/- 23 mm Hg in Group A), PaO2 decreased at OLV-10 (305 +/- 46 mm Hg), OLV-20 (203 +/- 20 mm Hg), and OLV-30 (178 +/- 18 mm Hg) in Group P (P < 0.05) and at OLV-20 (354 +/- 25 mm Hg) and OLV-30 (325 +/- 17 mm Hg) in Group A (P < 0.05). PaO2 values differed between the groups at OLV-20 and OLV-30 (P < 0.05). Pulmonary artery pressure and cardiac output...Continue Reading

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Citations

Feb 26, 2004·Anesthesia and Analgesia·Nicolas DalibonMarc Fischler
Feb 27, 2004·Journal of Intensive Care Medicine·Cassie C Dietrich, Joseph D Tobias
Mar 24, 2012·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Zhijian YouShanglong Yao
Feb 3, 2012·Physiological Reviews·J T SylvesterJeremy P T Ward
Aug 16, 2012·Seminars in Cardiothoracic and Vascular Anesthesia·Michele L SumlerRandal S Blank
May 7, 2009·Anesthesiology·Waheedullah Karzai, Konrad Schwarzkopf
Mar 15, 2006·Current Opinion in Anaesthesiology·Göran Hedenstierna, Arne Tenling
Jan 15, 2015·Anesthesiology·Andrew B Lumb, Peter Slinger
Oct 6, 2006·Current Opinion in Anaesthesiology·Rolf DembinskiRalf Kuhlen
Dec 21, 2010·Anesthesiology·Hadrien RozéAlexandre Ouattara
Jul 22, 2008·British Journal of Anaesthesia·N P TalbotK L Dorrington

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