title: [Hemodynamic changes during continuous infusion with dobutamine in candidates for lung transplantation. Lung Transplantation Group].
abstract: BACKGROUND
  The aim of this study is to analyze the effects of dobutamine (DBT) on pulmonary and systemic hemodynamics and oxygenation in lung transplant candidates.
  
  
  METHODS
  Forty-five patients (21M, 24F) to be introduced in waiting list for lung transplantation were studied (14 pulmonary fibrosis, 15 COPD, and 16 cystic fibrosis). They were studied awake, while spontaneously breathing in two different phases: baseline--O2 100%; DBT phase--O2 100% after 10 minutes of DBT continuous infusion (10 mcg/Kg/min). Blood gas samples and hemodynamic data were collected during right heart catheterization. Data were statistically analyzed with Student's "t" test and values for p < 0.05 were considered as significant.
  
  
  RESULTS
  During DBT phase, a significant increase of cardiac output with a decreasing in systemic and pulmonary vascular resistance was observed. Since the fall in pulmonary vascular resistance (PVRI) was not proportional to the increase of cardiac output, mean pulmonary artery pressure and transpulmonary gradient increased. The prevalent role of vascular recruitment as mechanism in PVRI reduction during DBT is supported by the concomitant fall in PaO2/FiO2. This strongly suggests a worsening of regional Va/Qc due to an increased perfusion of poorly ventilated areas.
  
  
  CONCLUSIONS
  DBT reduces PVRI through a recruitment of vessels due to an increase of pulmonary flow. Dobutamine has a favorable hemodynamic effect in mild-to-moderate pulmonary hypertension in lung transplant candidates.
authors.affiliation: Istituto di Anestesia e Rianimazione, Università degli Studi di Roma La Sapienza. dellarocca@uniroma1.it
authors.forename: G
authors.initials: G
authors.lastname: Della Rocca
authors.forename: F
authors.initials: F
authors.lastname: Pierconti
authors.forename: C D
authors.initials: CD
authors.lastname: Vizza
authors.forename: F
authors.initials: F
authors.lastname: Pugliese
authors.forename: C
authors.initials: C
authors.lastname: Coccia
authors.forename: L
authors.initials: L
authors.lastname: Pompei
authors.forename: M G
authors.initials: MG
authors.lastname: Costa
authors.forename: F
authors.initials: F
authors.lastname: Venuta
authors.forename: E A
authors.initials: EA
authors.lastname: Rendina
authors.forename: P
authors.initials: P
authors.lastname: Pietropaoli
authors.forename: A
authors.initials: A
authors.lastname: Gasparetto
mesh_terms: D000328:Adult; D002316:Cardiotonic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D004280:Dobutamine / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000188:drug therapy*; D007263:Infusions, Parenteral; D016040:Lung Transplantation; D008297:Male
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine