Combination therapy with inhaled nitric oxide and intravenous dobutamine during pulmonary hypertension in the rabbit

被引:34
作者
Bradford, KK
Deb, B
Pearl, RG [1 ]
机构
[1] Stanford Univ, Med Ctr, Dept Anesthesia, Stanford, CA 94305 USA
[2] Stanford Univ, Med Ctr, Dept Pediat, Stanford, CA 94305 USA
关键词
dobutamine; inhaled nitric oxide; pulmonary hypertension; right ventricular failure; vasodilator;
D O I
10.1097/00005344-200008000-00002
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Combination therapy with an intravenous inovaso-dilator and inhaled nitric oxide (NO) may be appropriate in patients with pulmonary hypertension and associated right ventricular failure. We examined whether dobutamine and inhaled NO would have additive pulmonary vasodilator effects in experimental pulmonary hypertension. Pulmonary hypertension was produced in anesthetized, mechanically ventilated rabbits hv infusion of U46619. a thromboxane analogue. Dobutamine was administered in increasing doses (2.5-20 mu g/kg/min) with and without inhaled NO (40 ppm). Dobutamine produced dose-dependent decreases in pulmonary vascular resistance (PVR) and mean arterial pressure (MAP) and increases in cardiac output (CO). inhaled NO alone decreased pulmonary artery pressure (PAP) and PVR with no effect on MAP or CO. The effects of dobutamine and inhaled NO were additive, so that at each dose of dobutamine, inhaled NO decreased PAP and PVR with no effect on systemic hemodynamics. This study suggests that the combination of dobutamine and inhaled NO should produce additive pulmonary vasodilation in patients with pulmonary hypertension and associated right ventricular dysfunction.
引用
收藏
页码:146 / 151
页数:6
相关论文
共 51 条
[1]   THROMBOXANE-A(2) AND PROSTACYCLIN BIOSYNTHESIS IN CHILDREN AND ADOLESCENTS WITH PULMONARY VASCULAR-DISEASE [J].
ADATIA, I ;
BARROW, SE ;
STRATTON, PD ;
MIALLALLEN, VM ;
RITTER, JM ;
HAWORTH, SG .
CIRCULATION, 1993, 88 (05) :2117-2122
[2]   Pulmonary vasodilation by nitric oxide gas and prodrug aerosols in acute pulmonary hypertension [J].
Adrie, C ;
Ichinose, F ;
Holzmann, A ;
Keefer, L ;
Hurford, WE ;
Zapol, WM .
JOURNAL OF APPLIED PHYSIOLOGY, 1998, 84 (02) :435-441
[3]   Combined therapy with inhaled nitric oxide and intravenous vasodilators during acute and chronic experimental pulmonary hypertension [J].
Aranda, M ;
Bradford, KK ;
Pearl, RG .
ANESTHESIA AND ANALGESIA, 1999, 89 (01) :152-158
[4]  
ARANDA M, 1998, ANESTHESIOL CLIN N A, V16, P235
[5]   Aerosolization of novel nitric oxide donors selectively reduce pulmonary hypertension [J].
Brilli, RJ ;
Krafte-Jacobs, B ;
Smith, DJ ;
Passerini, D ;
Moore, L ;
Ballard, ET .
CRITICAL CARE MEDICINE, 1998, 26 (08) :1390-1396
[6]   The pressure-overloaded right ventricle in pulmonary hypertension [J].
Bristow, MR ;
Zisman, LS ;
Lowes, BD ;
Abraham, WT ;
Badesch, DB ;
Groves, BM ;
Voelkel, NF ;
Lynch, DMB ;
Quaife, RA .
CHEST, 1998, 114 (01) :101S-106S
[7]   THROMBOXANE A(2) MIMETIC U-46619 INDUCES SYSTEMIC AND PULMONARY-HYPERTENSION AND DELAYED TACHYPNEA IN THE GOAT [J].
CARRITHERS, JA ;
BROWN, D ;
LIU, F ;
ORR, JA .
JOURNAL OF APPLIED PHYSIOLOGY, 1994, 77 (03) :1466-1473
[8]   AN IMBALANCE BETWEEN THE EXCRETION OF THROMBOXANE AND PROSTACYCLIN METABOLITES IN PULMONARY-HYPERTENSION [J].
CHRISTMAN, BW ;
MCPHERSON, CD ;
NEWMAN, JH ;
KING, GA ;
BERNARD, GR ;
GROVES, BM ;
LOYD, JE .
NEW ENGLAND JOURNAL OF MEDICINE, 1992, 327 (02) :70-75
[9]  
Coddens J, 1993, J Cardiothorac Vasc Anesth, V7, P321, DOI 10.1016/1053-0770(93)90013-B
[10]   EFFECTS OF VASOACTIVE DRUGS ON THROMBOXANE-A2 MIMETIC-INDUCED PULMONARY-HYPERTENSION IN NEWBORN LAMBS [J].
CROWLEY, MR ;
FINEMAN, JR ;
SOIFER, SJ .
PEDIATRIC RESEARCH, 1991, 29 (02) :167-172