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Zhonghua yi xue za zhi · Aug 2009
[The acute effects of inhaled iloprost on hemodynamics and oxygenation in chronic thromboembolic pulmonary hypertension].
- Ling Luo, Yuan-Hua Yang, Na Cui, Wan-Mu Xie, Zhen-Guo Zhai, Zhan-Hong Ma, and Chen Wang.
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Diseases, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.
- Zhonghua Yi Xue Za Zhi. 2009 Aug 11;89(30):2103-5.
ObjectiveTo evaluate the acute effects of inhaled iloprost on hemodynamics and oxygenation in chronic thromboembolic pulmonary hypertension (CTEPH).MethodsA prospective study was made. Eighteen patients with CTEPH were enrolled. At right heart catheterisation, iloprost was inhaled at 20 microg for 10 - 15 min. Compare the value of heart rate (HR), mean blood pressure (mBP), mean pulmonary arterial hypertension (mPAP), right atrium pressure (RAP), pulmonary arterial wedge pressure (PAWP), cardiac output (CO), pulmonary vascular resistance (PVR), systemic vascular resistance (SVR), arterial partial pressure of oxygen (PaO2), arterial oxygen saturation (SaO2), mixed venous saturation (SvO2), pulmonary shunt fraction (Qs/Qt), alveolar-arterial partial pressure of oxygen [P ( A-a) O2] before to after inhaled iloprost in these patients.ResultsSignificant changes (before to after inhalation): mPAP, (53 +/- 11) to (47 +/- 14) mm Hg (P < 0.01); PVR, (821 +/- 194) to (681 +/- 199) dyn x s x cm(-5) (P < 0.01); RAP, (10 +/- 6) to (7 +/- 6) mm Hg (P < 0.01). However, HR, PAWP, mBP, CO and SVR had no significant changes. At the same time, inhaled iloprost significantly decreased PaO2 from (58 +/- 11) to (52 +/- 6) mm Hg (P < 0.01) and increased Qs/Qt from (27 +/- 11)% to (33 +/- 9)% (P < 0.01)and P(A-a) O2 from (86 +/-39) to (93 +/- 38) mm Hg (P < 0.01).ConclusionInhaled iloprost might instantly improve hemodynamics in CTEPH, but at the same time it increased arteriovenous shunts which resulted in lower PaO2.
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