Chest
Almitrine in Acute Respiratory Failure: Effects on Pulmonary Gas Exchange and Circulation
Section snippets
Subjects
Ten consecutive patients without a history of previous lung disease, suffering from acute respiratory failure (ARF) secondary to extrapulmonary processes, were studied. The protocol was approved by the Human Research Committee of our institution, and informed written consent was obtained from patients' next-of-kin. Sex, age, and diagnosis of the patients are shown in Table 1. All of them were intubated and mechanically ventilated. Bilateral diffuse pulmonary infiltrates were observed in chest
Results
The etiology of ARF in our patients was shock, sepsis, or both. Massive upper gastrointestinal tract bleeding was present in five patients. Sepsis was always of abdominal origin except in patient 6 who had right humerus osteomyelitis due to Staphylococcus aureus (Table 1). Age in the almitrine group (65.9±14.0 years, mean±SD) was similar to the control group (65.8±14.0 years). Patients were studied between day 1 and 5 from start of mechanical ventilation. Respiratory rate and e were
DISCUSSION
Almitrine was effective in increasing PaO2 in all our patients. The rise was immediate, but in most cases, PaO2 began to decline even before the completion of the infusion. Several mechanisms can account for the improvement in PaO2. An increase in t in the presence of constant o2 resulted in a rise in PvO2 which could have contributed to the improvement in PaO2. This mechanism is probably responsible for the small variations in PaO2 in patients 3, 7, and 8 at ALM 30, but for the
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Cited by (20)
Acute respiratory distress syndrome: Potential pharmacologic interventions
2000, Clinics in Chest MedicineCitation Excerpt :The second trial compared the use of almitrine in ARDS patients with controls, and showed a significant increase in Pa o2, and a reduction in both the Pa o2–PAO2 gradient and venous admixture. Similar results have been reproduced in other small studies.136 The use of almitrine bismesylate with NO has also been investigated.
Pharmacologic adjuncts to mechanical ventilation in acute respiratory distress syndrome
1998, Critical Care Clinics
Manuscript received May 1; revision accepted August 20.