par Melot, Christian ;Naeije, Robert ;Hallemans, Roger ;Mols, Pierre ;Lejeune, Philippe
Référence European journal of respiratory diseases. Supplement, 64, 126, page (249-254)
Publication Publié, 1983
Article révisé par les pairs
Résumé : Almitrine bismesylate 100 mg orally was given to eight patients with severe chronic obstructive pulmonary disease (COPD). In five patients, gasometric, haemodynamic and lung mechanics parameters, and almitrine plasma levels were measured at baseline and every hour up to five hours after almitrine bismesylate intake. Maximal almitrine plasma levels were reached after 2 hours (89 ± 41 ng/ml, mean ± SEM) and persisted up to the fifth hour (68 ± 25 ng/ml). Pulmonary vascular resistance increased significantly from baseline 433 ± 120 to 503 ± 124, p < 0.05 at the second hour and to 509 ± 119, p < 0.05 at the fifth hour. Arterial oxygen saturation increased significantly from baseline 81.7 ± 4.9% to 84.5 ± 5.0, p < 0.05 at the second hour and to 84.5 ± 4.6, p < 0.05 at the fifth hour. Venous admixture decreased significantly from baseline 35 ± 9% to 30 ± 9, P < 0.05 at the second hour and to 28 ± 9, p < 0.01 at the fifth hour. Pulmonary artery mean pressure, cardiac output and minute ventilation did not change. The continuous distributions of ventilation-perfusion ratios (V̇A/Q̇), using the multiple inert gas elimination technique, were determined in six patients at baseline and two hours after almitrine bismesylate intake. An improvement in V̇A/Q̇ matching was observed after almitrine with a diversion of an average of 15% of total blood flow from hypoxic units (V̇A/Q̇ between 0.08 and 0.4) to normoxic units (V̇A/Q̇ between 0.5 and 1.8). In conclusion in severe COPD, pharmacological increase in pulmonary vascular tone by almitrine bismesylate improves pulmonary gas exchange.