Inhaled prostacyclin (PGI2) is an effective addition to the treatment of pulmonary hypertension and hypoxia in the operating room and intensive care unit

Haché, Manon; Denault, André; Bélisle, Sylvain; Couture, Pierre; Babin, Denis; Tétrault, Francine; Guimond, Jean-Gilles

doi:10.1007/bf03017361

Cited by 50 publications

(36 citation statements)

References 25 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Prostacyclin and its analogues offer a good alternative to NO and there are several reports of the use of inhaled epoprostenol in the peri-operative setting. A study that included 35 patients with PH showed successful use of inhaled prostacyclin in the operating theatre and intensive care unit [72]. Iloprost has a longer half-life than prostacyclin and is less likely to cause rebound phenomena after discontinuation.…”

Section: Vasodilatorsmentioning

confidence: 99%

Pulmonary hypertension and its management in patients undergoing non‐cardiac surgery

2014

View full text Add to dashboard Cite

SummaryPulmonary hypertension is a complex disorder of the pulmonary vasculature that leads to increased peri-operative morbidity and mortality. Non-cardiac surgery constitutes a significant risk in patients with pulmonary hypertension. The management of right ventricular failure is inherently challenging and fraught with life-threatening consequences. A thorough understanding of the pathophysiology, the severity of the disease and its treatment modalities is required to deliver optimal peri-operative care. This review provides an evidence-based overview of the definition, classification, pathophysiology, diagnosis and treatment of pulmonary hypertension and focuses on the peri-operative management and treatment of pulmonary hypertensive crises in a non-cardiac setting.

show abstract

Section: Vasodilatorsmentioning

confidence: 99%

Pulmonary hypertension and its management in patients undergoing non‐cardiac surgery

2014

View full text Add to dashboard Cite

show abstract

“…(9,33 ± 3,83 mmHg vs 17,09 ± 6,41 mmHg, P < 0,05). Le ratio de la pression artérielle pulmonaire moyenne sur la pression artérielle systémique a diminué pendant cette période (0,28 ± 0,08 vs 0,45 ± 0,17, P < 0,05).…”

unclassified

Inhaled iloprost controls pulmonary hypertension after cardiopulmonary bypass

Theodoraki

Rellia

Thanopoulos

et al. 2002

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

P Pu ur rp po os se e: : Severe pulmonary hypertension (PH) is a major cause of right ventricular (RV) dysfunction. Various iv vasodilator modalities have been used with limited results because of lack of pulmonary selectivity. The aim of the present controlled study was to evaluate the efficacy of inhaled iloprost, a synthetic prostacyclin analogue, in patients with elevated pulmonary vascular resistance (PVR) immediately after separation from cardiopulmonary bypass (CPB).M Me et th ho od ds s: : Twelve patients with persistent PH after discontinuation of CPB were included in the study. In all patients standard hemodynamic monitoring was used. Inhaled iloprost was administered via nebulized aerosol at a cumulative dose of 0.2 µg·kg -1 for a total duration of 20 min. Complete sets of hemodynamic measurements were performed before inhalation (baseline), during and after cessation of the inhalation period. Echocardiographic monitoring of RV function was also used.R Re es su ul lt ts s: : Inhaled iloprost induced a reduction in the transpulmonary gradient at the end of the inhalation period in comparison to baseline (9.33 ± 3.83 mmHg vs 17.09 ± 6.41 mmHg, P < 0.05). The mean pulmonary artery pressure to systemic artery pressure ratio decreased over this period (0.28 ± 0.08 vs 0.45 ± 0.17, P < 0.05). A statistically significant decrease of the PVR to systemic vascular resistance ratio was also observed (0.15 ± 0.05 vs 0.21 ± 0.05, P < 0.05). Improved indices of RV function were observed in echocardiographic monitoring.C Co on nc cl lu us si io on n: : Inhaled iloprost appears to be a selective pulmonary vasodilator and may be effective in the initial treatment of PH and the improvement of RV performance in the perioperative setting. (9,33 ± 3,83 mmHg vs 17,09 ± 6,41 mmHg, P < 0,05). Le ratio de la pression artérielle pulmonaire moyenne sur la pression artérielle systémique a diminué pendant cette période (0,28 ± 0,08 vs 0,45 ± 0,17, P < 0,05). Une baisse statistiquement significative du ratio de la RVP sur la résistance vasculaire générale a été aussi observée (0,15 ± 0,05 vs 0,21 ± 0,05, P < 0,05 Objectif : L'hypertension pulmonaire sévère (HP) est une cause majeure de dysfonction du ventricule droit (VD). Diverses modalités vasodilatatrices iv ont été utilisées et ont donné des résultats limités, étant donné le manque de sélectivité pulmonaire. Notre but était d'é-valuer l'efficacité de l'inhalation d'iloprost, un analogue de la prostacycline synthétique, chez des patients qui présentent une résistance vasculaire pulmonaire (RVP) élevée immédiatement après le sevrage de la circulation extracorporelle (CEC). Méthode : Douze patients présentant une HP persistante après l'interruption de la CEC ont été inclus dans l'étude. Une surveillance standard des paramètres hémodynamiques a été utilisée pour tous les patients. L'administration d'iloprost a été faite à l'aide d'un nébuliseur Résultats : L'iloprost inhalé a provoqué une réduction du gradient transpulmonaire à la fin de l'inhalation, en comparaison avec les m...

show abstract

“…At the Montreal Heart Institute, iPGI 2 (Hache et al, 2001;Hache et al, 2003) and inhaled milrinone (Lamarche et al, 2005;Lamarche et al, 2007) are commonly administered to patients when PH and RV dysfunction occur before or after cardiac surgery. Oral sildenafil and iNO are also used in refractory cases in the ICU.…”

Section: Experience At the Montreal Heart Institutementioning

confidence: 99%

A Pathophysiological Approach to Understanding Pulmonary Hypertension in Cardiac Surgery

Nguyen¹,

Deschamps²,

Perrault³

et al. 2012

Perioperative Considerations in Cardiac Surgery

View full text Add to dashboard Cite

Inhaled prostacyclin (PGI2) is an effective addition to the treatment of pulmonary hypertension and hypoxia in the operating room and intensive care unit

Abstract: Inhaled PGI2 can be useful in the treatment of patients with PHT and severe hypoxia. It can however be associated with systemic side effects.

Cited by 50 publications

References 25 publications

Pulmonary hypertension and its management in patients undergoing non‐cardiac surgery

Pulmonary hypertension and its management in patients undergoing non‐cardiac surgery

Inhaled iloprost controls pulmonary hypertension after cardiopulmonary bypass

A Pathophysiological Approach to Understanding Pulmonary Hypertension in Cardiac Surgery

Contact Info

Product

Resources

About