Almitrine fails to improve oxygenation during one-lung ventilation with sevoflurane anesthesia.
J Cardiothorac Vasc Anesth
; 28(4): 919-24, 2014 Aug.
Article
in En
| MEDLINE
| ID: mdl-24016684
ABSTRACT
OBJECTIVE:
Almitrine enhances hypoxic pulmonary vasoconstriction (HPV) and can improve hypoxemia related to one-lung ventilation (OLV). Studies using almitrine have been conducted without inhaled anesthetics because they could inhibit HPV, counteracting the effect of almitrine. This hypothesis, however, has not been confirmed. This study's aim was to evaluate whether almitrine could improve oxygenation when administered during OLV with sevoflurane anesthesia.DESIGN:
A prospective, randomized, double-blind, placebo-controlled trial.SETTING:
A tertiary care, university teaching hospital.PARTICIPANTS:
Thirty adult patients undergoing open-chest thoracic surgery.INTERVENTIONS:
Patients were assigned randomly to receive almitrine or placebo during OLV. Respiratory and hemodynamic variables were recorded continuously. Anesthesia was maintained with sevoflurane and remifentanil. Intraoperative techniques and medical teams were the same all over the study. MEASUREMENTS AND MAINRESULTS:
Respiratory and hemodynamic variables were measured during two-lung ventilation and during open-chest OLV. Two-way repeated-measures analysis of variance was used to compare the effects of almitrine and placebo. During OLV, PaO2 and shunt fraction worsened in all patients without significant differences between groups. At 30-minutes of OLV, PaO2 was 184±67 mmHg in the almitrine group and 145±56 mmHg in the placebo group, while shunt fraction were 31%±6% and 36%±13%, respectively. Mean pulmonary artery pressure was higher in the almitrine group (31±5 v 24±5 mmHg, p<0.001).CONCLUSIONS:
During anesthesia with sevoflurane for open-chest OLV, almitrine failed to improve oxygenation and increased pulmonary artery pressure. The combination of sevoflurane and almitrine should, therefore, be avoided.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Oxygen Consumption
/
Almitrine
/
One-Lung Ventilation
/
Hemodynamics
/
Anesthesia, General
/
Hypoxia
/
Methyl Ethers
Type of study:
Clinical_trials
/
Observational_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Cardiothorac Vasc Anesth
Journal subject:
ANESTESIOLOGIA
/
CARDIOLOGIA
Year:
2014
Document type:
Article
Affiliation country:
Spain