[Effect of almitrine on arterial gases in patients with chronic respiratory insufficiency. Comparison with doxapram. Preliminary results].
We compared the effects of almitrine and doxapram on the arterial blood gases and ventilation of patients with chronic respiratory insufficiency and chronic hypercapnia and hypoxemia. Sixteen long-term in-patients were randomly allocated to one of the following treatment groups: the first group (8 patients) received IV almitrine 0.5 mg/kg and the second group (8 patients) IV doxapram 1 mg/kg by IV perfusion during 30 min. All gave their informed consent. Arterial blood gases and ventilation were measured 10 min and 5 min before treatment, at the 5th, 15th and 25th min of perfusion time, and 5, 10 and 15 min after infusion. There was a marked increase in paO2 in almitrine-treated patients, which was maximum at the 25th min of infusion (+ 14.6 mm Hg, p < 0.001), but only a slight improvement was observed in the doxapram group (+ 3.3 mm Hg, p < 0.05). After almitrine the maximum mean paCO2 decrease was at the 10th min after perfusion (-6.9 mm Hg, p < 0.001); after doxapram the maximum decrease, although highly significant, was much less (-2.8 mm Hg, p < 0.01). Thus, at the presently used and well-tolerated doses, almitrine is much more efficient than doxapram in improving gas exchange in patients with chronic hypoxemia and hypercapnia. However, complementary studies using higher dosage of doxapram are warranted.
D000368:Aged; D015765:Almitrine; D002245:Carbon Dioxide / Q000097:blood*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002908:Chronic Disease; D004315:Doxapram / Q000627:therapeutic use*; D006801:Humans; D006935:Hypercapnia / Q000188:drug therapy; D000860:Hypoxia / Q000188:drug therapy; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D010879:Piperazines / Q000627:therapeutic use*; D012131:Respiratory Insufficiency / Q000097:blood / Q000188:drug therapy*; D014227:Triazines / Q000627:therapeutic use*
D000697:Central Nervous System Stimulants; D010879:Piperazines; D014227:Triazines; D002245:Carbon Dioxide; D004315:Doxapram; D015765:Almitrine; D010100:Oxygen
Invloed van almitrine op de arteriële gassen bij patiënten met chronische respiratoire insufficiëntie. Vergelijking met doxapram. Voorlopige resultaten.