title: Landiolol reduces hemodynamic responses to bronchoscopy-assisted suctioning in intubated ICU patients.
abstract: Landiolol is an ultra-short-acting β1-selective antagonist developed in Japan that was recently approved for the treatment of tachycardia in intensive care units (ICUs). This study investigated the protective effects of landiolol against the cardiovascular responses during bronchoscopic endotracheal suctioning. This study enrolled 15 patients requiring orotracheal intubation in an ICU. All of the patients required endotracheal suctioning using fiber bronchoscopy while sedated at a Ramsay Scale of 2-3. All subsequent suctioning procedures were assigned randomly to three groups using a cross-over design: saline as a placebo (group C) or 20 or 40 μg kg(-1) min(-1) landiolol, respectively (groups L20 and L40). The infusion was started 3 min before bronchoscopy and continued for 6 min. The central venous pressure (CVP) heart rate (HR) and arterial blood pressure (BP) were recorded. Fourteen patients completed the investigation, and 30 procedures (n = 10/group) were analyzed. The suctioning significantly increased the CVP, HR, and BP in groups C and L20, although the changes in BP were of shorter duration in group L20. No significant increase in the hemodynamic parameters was observed in group L40. The administration of landiolol 40 μg kg(-1) min(-1) prevented a harmful hyperdynamic circulatory response to bronchoscopic endotracheal suctioning, without obvious decreases in HR or BP after the intervention.
authors.affiliation: Department of Anesthesiology and Resuscitation, Hamamatsu University School of Medicine, 1-20-1 Handayama, Nagoya, 431-3192 Japan ; Department of Pediatrics and Developmental Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan.
authors.forename: Junpei
authors.initials: J
authors.lastname: Tochikubo
authors.affiliation: Department of Anesthesiology and Resuscitation, Hamamatsu University School of Medicine, 1-20-1 Handayama, Nagoya, 431-3192 Japan.
authors.forename: Yushi U
authors.initials: YU
authors.lastname: Adachi
authors.affiliation: Department of Pediatrics and Developmental Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ejima
authors.affiliation: Department of Pediatrics and Developmental Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan ; Department of Pediatrics and Developmental Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Numaguchi
authors.affiliation: Department of Pediatrics and Developmental Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Matsuda
authors.affiliation: Department of Anesthesiology and Resuscitation, Hamamatsu University School of Medicine, 1-20-1 Handayama, Nagoya, 431-3192 Japan.
authors.forename: Shigehito
authors.initials: S
authors.lastname: Sato
authors.affiliation: Department of Anesthesiology and Resuscitation, Hamamatsu University School of Medicine, 1-20-1 Handayama, Nagoya, 431-3192 Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Shiiya
keywords: Endotracheal suctioning; Fiber bronchoscopy; Hemodynamic response; Landiolol