Document Detail


Amrinone improves lung compliance in patients receiving mechanical ventilation for cardiogenic pulmonary edema.
MedLine Citation:
PMID:  9181165     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Decrease in lung compliance is one of the major causes of respiratory failure. We investigated whether amrinone could improve lung compliance. METHODS: We selected 20 consecutive patients with respiratory failure due to severe cardiogenic pulmonary edema to receive mechanical ventilation. Patients were administered a bolus injection (1 mg.kg-1) over 10 min followed by continuous intravenous infusion (10 micrograms.kg-1.min-1) of amrinone. Lung compliance, blood gas values, hemodynamic parameters, and sample plasma amrinone levels were assessed over a 120-min period after the onset of the continuous infusion of amrinone. RESULTS: Ten min following amrinone infusion, dynamic compliance (Cdyn) and static compliance (Cst) increased from 30 +/- 11 to 36 +/- 12 ml/cm H2O and from 37 +/- 12 to 42 +/- 13 ml/cm H2O, respectively (P < 0.01). Plasma amrinone levels reached a therapeutic level as vasodilator and positive inotropic effects at 10 min after amrinone infusion. The significant change in mean pulmonary artery pressure and pulmonary artery wedge pressure occurred later than the change in compliance of respiratory system. However, there were significant correlations between the mean pulmonary artery pressure and Cdyn (r = 0.36, P < 0.01) and Cst (r = 0.44, P < 0.01), as well as between plasma amrinone levels and Cdyn (r = 0.30, P < 0.05) and Cst (r = 0.41, P < 0.01). CONCLUSIONS: Amrinone-induced improvement in lung compliance was considered mainly to be due to an increase in the number of functioning lung units by improvement of the hemodynamics and a direct positive effect of amrinone on respiratory muscle contraction.
Authors:
S Takeda; T Takano; K Nakanishi; J Nejima; M Takayama; C Kim; R Ogawa
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  41     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-07-31     Completed Date:  1997-07-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  624-8     Citation Subset:  IM    
Affiliation:
Department of Intensive Care Medicine, Nippon Medical School, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Amrinone / blood,  therapeutic use*
Blood Gas Analysis
Cyclic AMP / blood
Cyclic GMP / blood
Female
Heart Failure / complications*,  physiopathology
Hemodynamics / drug effects
Humans
Lung Compliance / drug effects*
Male
Myocardial Contraction / drug effects
Pulmonary Edema / drug therapy*,  etiology,  physiopathology*
Respiration, Artificial*
Respiratory Mechanics / drug effects
Vasodilator Agents / blood,  therapeutic use*
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 60-92-4/Cyclic AMP; 60719-84-8/Amrinone; 7665-99-8/Cyclic GMP

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