title: [Effect of nebulised iloprost combined with inhaled nitric oxide and oral sildenafil on lung transplant patients. Therapeutic efficacy in pulmonary hypertension during surgery].
abstract: OBJECTIVE
  There is a high incidence of pulmonary hypertension during the lung transplant peri-operative period, and could lead to a haemodynamic deterioration that may require the need of extracorporeal circulation. Our aim was to study the haemodynamic effects on the pulmonary and systemic circulation of the combination of inhaled nitric oxide and iloprost and oral sildenafil in patients with severe pulmonary hypertension during lung transplant surgery.
  
  
  METHODS
  Seventeen patients received 10μg of nebulised iloprost during the peri-operative period of the lung transplant when their mean pulmonary pressure exceeded 50mmHg. AU the patients received 50mg of oral sildenafil 30min before anaesthetic induction, 20ppm of inhaled nitric oxide after tracheal intubation. The haemodynamic and respiratory variables were recorded at baseline (after anaesthetic induction), prior to the administering of iloprost, and at 5 and 30min after it was given.
  
  
  RESULTS
  The administering of iloprost significantly reduced the pulmonary arterial pressure and significantly increases the cardiac Índex and the right ventrícular ejection fractíon. There were no signíficant changes occurred in the systemic arterial pressure.
  
  
  CONCLUSIONS
  The triple combination significantly reduces the pulmonary pressures in the lung transplant peri-operative and should be considered when there is severe pulmonary hypertension during the surgery or during the immediate post-operative period of lung transplantation.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España. Electronic address: jmrabanal@humv.es.
authors.forename: J M
authors.initials: JM
authors.lastname: Rabanal Llevot
authors.forename: B
authors.initials: B
authors.lastname: Cimadevilla Calvo
authors.forename: J M
authors.initials: JM
authors.lastname: Cifrian Martinez
authors.forename: C
authors.initials: C
authors.lastname: Ruisanchez Villar
authors.forename: R
authors.initials: R
authors.lastname: Mons Lera
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D003550:Cystic Fibrosis / Q000601:surgery; D004280:Dobutamine / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology; D016285:Iloprost / Q000008:administration & dosage* / Q000627:therapeutic use; D007431:Intraoperative Complications / Q000188:drug therapy*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D009569:Nitric Oxide / Q000008:administration & dosage* / Q000627:therapeutic use; D009638:Norepinephrine / Q000008:administration & dosage; D010879:Piperazines / Q000008:administration & dosage* / Q000627:therapeutic use; D011300:Preoperative Care; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000601:surgery; D011687:Purines / Q000008:administration & dosage / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D009569:Nitric Oxide; D004280:Dobutamine; D000068677:Sildenafil Citrate; D016285:Iloprost; D009638:Norepinephrine