ABSTRACT
Effects of a new respiratory stimulant almitrine on lung ventilation and gas exchange were studied in 15 patients suffering from chronic respiratory insufficiency. The variables examined were measured during 4 consecutive periods lasting 30 min each. During the first period initial data were collected. From the second period to the end of the investigation, oxygen, 1.5 1/min, was administered. During the third phase, almitrine was infused at a dose of 0.33 mg/kg. Administration of oxygen increased arterial oxygen tension without change in lung ventilation. Infusion of almitrine increased minute ventilation by 27%. The increase in VE was entirely due to increase in tidal volume. There was a significant rise in arterial oxygen tension and decrease in carbon dioxide tension. Hyperventilation and improvement in blood gases were still observed 30 min after the infusion was completed. It is suggested that almitrine increases minute ventilation in patients with respiratory failure receiving oxygen.
Subject(s)
Bronchitis/therapy , Central Nervous System Stimulants/therapeutic use , Oxygen Inhalation Therapy , Piperazines/therapeutic use , Adult , Aged , Almitrine , Blood Pressure/drug effects , Chronic Disease , Female , Heart Rate/drug effects , Humans , Male , Middle Aged , Pulmonary Gas Exchange/drug effects , Respiration/drug effects , Tidal Volume , Ventilation-Perfusion Ratio/drug effectsABSTRACT
In 16 patients with chronic bronchitis and advanced cor pulmonale admitted to hospital due to heart failure, a controlled 6-weeks oxygen therapy, 17 h a day, was performed. The trial was started when patients were out of the exacerbation of the disease in a respiratory and circulatory steady state. Pulmonary hemodynamics, blood viscosity, packed cell volume and basic lung function data before and after oxygen therapy were compared. A significant fall of mean pulmonary arterial pressure from 42 to 30 mm Hg without a change in the cardiac output was found. Blood viscosity and packed cell volume-significantly decreased. Arterial oxygen tension did not significantly change. It seems that 17-hours per day oxygen therapy is sufficient to induce regression of anatomic changes in pulmonary arteries, a main cause of pulmonary hypertension in hypoxic cor pulmonale.
Subject(s)
Blood Viscosity , Hypertension, Pulmonary/therapy , Oxygen Inhalation Therapy/adverse effects , Pulmonary Heart Disease/blood , Adult , Aged , Cardiac Output , Female , Humans , Hypertension, Pulmonary/etiology , Male , Middle Aged , Pulmonary Heart Disease/complications , Pulmonary Heart Disease/physiopathologySubject(s)
Blood Viscosity , Hypertension, Pulmonary/therapy , Oxygen Inhalation Therapy , Pulmonary Heart Disease/therapy , Adult , Blood Pressure , Female , Humans , Hypertension, Pulmonary/physiopathology , Hypoxia/physiopathology , Hypoxia/therapy , Male , Middle Aged , Pulmonary Heart Disease/physiopathology , Time FactorsABSTRACT
Differing opinions about the use of digitalis in patients with cor pulmonale have led the authors to study haemodynamic effect of strophantin, a cardiotonic glycoside used as therapy of choice of decompensated cor pulmonale. Five patients with severe airways obstruction recovering from heart failure were studied. Ouabain at a dose of 0.01 mg/kg was infused into the pulmonary artery. Pulmonary artery pressure and flow were measured before, at the end of the infusion, 15 and 30 min after it. There was no change in the heart rate or mean pulmonary artery pressure and a slight increase in the pulmonary wedge pressure was observed after ouabain. The most important change concerned the pulmonary blood flow. The cardiac index rose from the initial 2.48 +/- 0.44 l/min/m2 to 3.67 +/- 1.3 l/min/m2 15 min after ouabain. The increase in cardiac output was entirely due to the increase in the stroke volume. Pulmonary vascular resistance fell from 502 +/- 208 dyn. s. cm-5 to 315 +/- 216 dyn. s. cm-5 15 min after ouabain. The findings support clinical preference for strophantin in patients with decompensated cor pulmonale.
