par Melot, Christian 
;Naeije, Robert ;Mols, Pierre ;Hallemans, Roger ;Lejeune, Philippe ;Jaspar, Nadine
Référence The American review of respiratory disease, 136, 5, page (1232-1236)
Publication Publié, 1987-11
;Naeije, Robert ;Mols, Pierre ;Hallemans, Roger ;Lejeune, Philippe ;Jaspar, Nadine Référence The American review of respiratory disease, 136, 5, page (1232-1236)
Publication Publié, 1987-11
Article révisé par les pairs
| Résumé : | Hemodynamics, blood gases, lung mechanics, and the distributions of ventilation-perfusion ratios (VA/Q) were studied before and after iv diltiazem, 0.5 mg/kg over 30 min, in 6 patients with pulmonary hypertension secondary to the adult respiratory distress syndrome (ARDS) ventilated with 7 to 20 cm H2O positive end-expiratory pressure (PEEP). Diltiazem decreased systemic and pulmonary arterial pressures without changes in cardiac output and in filling pressures of the heart, and with a slowing of heart rate. Pulmonary vascular resistances decreased from 401 +/- 59 to 329 +/- 58 dyne.s.cm-5.m2 (mean +/- SEM), p less than 0.01. Arterial Po2 decreased from 87 +/- 10 to 80 +/- 11 mm Hg (p less than 0.02) without changes in arterial PCO2, mixed venous PO2, and O2 consumption. Lung compliance and airway resistances did not change. Diltiazem increased true shunt from 23 +/- 5 to 30 +/- 7% of total blood flow (p less than 0.02) without other modification in the pattern of VA/Q distribution as measured by the multiple inert gas elimination technique. These results suggest that pulmonary vascular tone contributes to the maintenance of VA/Q matching in patients with ARDS. |
