[Aerosolized and intravenous prostacyclin during one-lung ventilation. Hemodynamic and pulmonary effects].
BACKGROUND
One-lung ventilation is frequently used in thoracic surgery. However, hypoxic pulmonary vasoconstriction of the atelectatic lung may produce pulmonary hypertension. The objective of the present study was to compare the acute effects of intravenous versus aerosolized prostacyclin (PGI(2)) on pulmonary and systemic circulation.


METHODS
PGI(2) was administered in 11 anesthetized and unilaterally ventilated pigs by infusion (5, 10, and 20 ng/kg body weight/min) and by inhalation (4, 8, and 16 ng/kg body weight/min) in a cross-over design.


RESULTS
Infusion of PGI(2) reduced both pulmonary (PVR) and systemic vascular resistance (SVR). Due to a concomitant increase in cardiac index (CI) mean arterial (MAP) and pulmonary artery pressures (MPAP) did not change significantly. In contrast, aerosolized PGI(2) produced a significant decrease in PVR (-21.4 to -32.8%) and MPAP (-12.0 to -17.8%) without affecting SVR, MAP, and CI. Arterial oxygenation tension (p(a)O(2)) was not affected.


CONCLUSIONS
During one-lung ventilation only aerosolized prostacyclin produced a selective pulmonary vasodilation.
Bund
M
M
Klinik für Anästhesiologie, Albert-Schweitzer-Krankenhaus, Northeim. michael.bund@ask-northeim.de
Henzler
D
D
Walz
R
R
Rossaint
R
R
Piepenbrock
S
S
Kuhlen
R
R
D000280:Administration, Inhalation; D000465:Algorithms; D000818:Animals; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D011464:Epoprostenol / Q000008:administration & dosage* / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D007275:Injections, Intravenous; D010100:Oxygen / Q000097:blood; D011652:Pulmonary Circulation / Q000187:drug effects* / Q000502:physiology; D012121:Respiration, Artificial; D013552:Swine; D014655:Vascular Resistance / Q000187:drug effects; D014664:Vasodilation / Q000187:drug effects
D000959:Antihypertensive Agents; D011464:Epoprostenol; D010100:Oxygen