[Influence of isosorbide dinitrate on haemodynamics and gas exchange in acute respiratory distress syndrome (author's transl)].
The effects of intravenous isosorbide dinitrate (ISDN: 3, 6, 9, and 12 mg/h) on systemic and pulmonary vasculature, gas exchange, and dynamic lung compliance were investigated in 7 controlled ventilated patients suffering from ARDS after trauma or in sepsis. Parameters were recorded before and after 20 min. ISDN infusion with 30 min interruption between the different dosage steps. Systemic circulation, heart rate, cardiac index, and stroke index remained grossly unchanged. MPAP was significantly decreased at 6, 9, and 12 mg/h ISDN to 61,7%, 61%, and 69,3% of initial value, as well as PCWP to 49,6% 45,5% and 41,5% of initial value. The drop of RVSWI at 6 and 9 mg/h ISDN to 59,1% and 63,2% also was statistically significant. There was an increase in Qs/Qt, AaDO2, and dynClung, though the increases were not statistically significant. O2availability remained unchanged. Administration of ISDN in ARDS causes an improvement in right ventricular function due to a reduction of pre- and afterload as well as intrapulmonary blood volume. In a similar manner increasing lung compliance may be explained by volume shif. The slight alterations of ventilation-perfusion-ratio as seen by increases in Qs/Qt and AaDO2 can be tolerated because of the unchanged O2availability.
D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use*; D008170:Lung Compliance / Q000187:drug effects; D010101:Oxygen Consumption / Q000187:drug effects*; D010313:Partial Pressure; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000188:drug therapy*
D007548:Isosorbide Dinitrate
Der Einfluss von Isosorbiddinitrat auf Hämodynamik und Gasaustausch bei der akuten respiratorischen Insuffizienz.