PMID- 12477682
OWN - NLM
STAT- MEDLINE
DCOM- 20030507
LR  - 20131121
IS  - 0832-610X (Print)
IS  - 0832-610X (Linking)
VI  - 49
IP  - 10
DP  - 2002 Dec
TI  - Iloprost improves hemodynamics in patients with severe chronic cardiac failure 
      and secondary pulmonary hypertension.
PG  - 1076-80
AB  - PURPOSE: Significant pulmonary hypertension is a predictor of postoperative right 
      heart insufficiency and increased mortality in patients undergoing orthotopic 
      heart transplantation. Since the use of iv vasodilators is limited by their 
      systemic effects, we evaluated the pulmonary and systemic hemodynamic effects of 
      inhaled aerosolized iloprost (IP) in heart transplant candidates with elevated 
      pulmonary vascular resistance (PVR). METHODS: Twenty-nine male heart transplant 
      candidates because of dilated or ischemic cardiomyopathy with elevated PVR were 
      included in the study. After assessing baseline hemodynamics, 50 micro g 
      aerosolized IP were administered by inhalation. RESULTS: Inhalation of iloprost 
      reduced PVR index (PVRI; 416 +/- 180 vs 349 +/- 173 dyn x sec(-1) x m(-2) x 
      cm(-5); P < 0.01) and mean pulmonary artery pressure (MPAP; 28.6 +/- 9 vs 24.2 
      +/- 9.1 mmHg; P < 0.01), but did not affect blood pressure or systemic vascular 
      resistance. An additional improvement of ventricular performance with an increase 
      of cardiac index (CI; 2.8 +/- 0.7 vs 2.6 +/- 0.7 L x min(-1) x m(-2); P < 0.05) 
      and a decrease of pulmonary capillary wedge pressure (PCWP; 15.6 +/- 6.8 vs 12.8 
      +/- 7.1 mmHg; P < 0.01) was observed after inhalation of IP. CONCLUSIONS: Inhaled 
      aerosolized iloprost effectively reduces MPAP and is accompanied by an increase 
      in CI and stroke index. Further advantages of iloprost inhalation are the lack of 
      adverse reactions and ease of administration. Iloprost may be a useful drug to 
      screen for vascular reactivity in cardiac transplantation patients.
FAU - Sablotzki, Armin
AU  - Sablotzki A
AD  - Clinic of Anesthesiology and Intensive Care Medicine, University of 
      Halle/Wittenberg, Halle/Saale, Germany. sablotzki@aol.com
FAU - Czeslick, Elke
AU  - Czeslick E
FAU - Schubert, Susann
AU  - Schubert S
FAU - Friedrich, Ivar
AU  - Friedrich I
FAU - Muhling, Jorg
AU  - Muhling J
FAU - Dehne, Marius G
AU  - Dehne MG
FAU - Grond, Stefan
AU  - Grond S
FAU - Hentschel, Thomas
AU  - Hentschel T
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Can J Anaesth
JT  - Canadian journal of anaesthesia = Journal canadien d'anesthesie
JID - 8701709
RN  - 0 (Aerosols)
RN  - 31C4KY9ESH (Nitric Oxide)
RN  - JED5K35YGL (Iloprost)
SB  - IM
MH  - Administration, Inhalation
MH  - Adult
MH  - Aerosols
MH  - Aged
MH  - Chronic Disease
MH  - Heart Failure/*drug therapy/physiopathology
MH  - Heart Transplantation
MH  - Hemodynamics/*drug effects
MH  - Humans
MH  - Hypertension, Pulmonary/*drug therapy/physiopathology
MH  - Iloprost/administration & dosage/*pharmacology
MH  - Male
MH  - Middle Aged
MH  - Nitric Oxide/administration & dosage/therapeutic use
EDAT- 2002/12/13 04:00
MHDA- 2003/05/08 05:00
CRDT- 2002/12/13 04:00
PHST- 2002/12/13 04:00 [pubmed]
PHST- 2003/05/08 05:00 [medline]
PHST- 2002/12/13 04:00 [entrez]
AID - 10.1007/BF03017906 [doi]
PST - ppublish
SO  - Can J Anaesth. 2002 Dec;49(10):1076-80. doi: 10.1007/BF03017906.