Document Detail


Effect of adenosine infusion on oxygen induced carbon dioxide retention in severe chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  8958889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In normal subjects intravenous adenosine infusion has been shown to stimulate ventilation with a consequent fall in arterial partial pressure of carbon dioxide (Paco2), probably by an action on the carotid bodies. The objective of this study was to determine whether the increase in Paco2 seen when patients with ventilatory failure secondary to chronic obstructive pulmonary disease (COPD) are given a high concentration of oxygen to breathe might be ameliorated by an intravenous infusion of adenosine. METHODS: Eight subjects with chronic stable ventilatory failure secondary to COPD were studied. Their mean (SE) forced expiratory volume in one second (FEV1) was 0.63 (0.12) 1 with forced vital capacity (FVC) of 1.63 (0.21) 1. They received continuous intravenous infusions of saline and adenosine in random order, double blind. The infusions were administered for two minutes at 20 micrograms/kg/min, increasing in increments of 20 micrograms/kg/min every two minutes to a maximum infusion rate of 80 micrograms/kg/min adenosine (or an equivalent saline infusion rate), or until side effects supervened. The infusions were continued at that rate for five minutes, after which the fractional inspired oxygen (FIO2) was raised to 0.50 during a further 20 minutes of the infusion at that rate. Haemoglobin oxygen saturation (SaO2) and transcutaneous PCO2 (PtcCO2) were monitored throughout the procedure. Spirometric tests were performed before and after each infusion. RESULTS: Adenosine infusion was accompanied by a fall in PtcCO2 from a mean (SE) of 7.29 (0.42) kPa to 6.95 (0.48) kPa: mean difference -0.34 (95% confidence interval, -0.56 to -0.11) kPa. During saline infusion oxygen administration resulted in an increase in transcutaneous PtcCO2 from 7.35 (0.34) kPa to 7.88 (0.28) kPa: mean difference 0.53 (95% CI 0.20 to 0.85) kPa. PtcCO2 did not rise above baseline levels when oxygen was administered during the adenosine infusion. A small fall in FVC was seen following adenosine infusion. CONCLUSIONS: The increase in PtcCO2 seen when patients with stable ventilatory failure secondary to severe COPD are given a high concentration of oxygen to breathe is counteracted by a continuous intravenous infusion of adenosine.
Authors:
T L Griffiths; S S Fernando; K B Saunders
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Thorax     Volume:  51     ISSN:  0040-6376     ISO Abbreviation:  Thorax     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1997-01-02     Completed Date:  1997-01-02     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1083-6     Citation Subset:  IM    
Affiliation:
Division of Physiological Medicine, St George's Hospital Medical School, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / therapeutic use*
Carbon Dioxide / blood
Cross-Over Studies
Double-Blind Method
Drug Administration Schedule
Female
Humans
Hypercapnia / etiology,  prevention & control*
Infusions, Intravenous
Lung Diseases, Obstructive / blood,  therapy*
Male
Oxygen / blood
Oxygen Inhalation Therapy / adverse effects*
Partial Pressure
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide; 58-61-7/Adenosine; 7782-44-7/Oxygen
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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