The Effects of Intravenous Almitrine on Oxygenation and Hemodynamics During One-Lung Ventilation

Abstract

Eight microg x kg(-1) x min(-1) IV almitrine limits one-lung ventilation-induced decrease in PaO2 without causing any hemodynamic modification in patients without pulmonary hypertension.

How do COPD and healthy‐lung patients tolerate the reduced volume ventilation strategy during OLV ventilation.

“…Indeed, the ventilated lung that is placed in the dependent position is prone to collapse during expiration because of surgical manipulations, mediastinum weight and exposure to high levels of FiO 2 18 . Even if the strategies used to correct OLV‐induced hypoxemia are now well described, 2,3,19 the influence of the pre‐operative lung status remains poorly documented specifically with regard to the actual reduction of V t during the OLV period. This study is, to our knowledge, the first to prospectively assess the course of lung function according to the pre‐operative respiratory status and a V t reduction strategy.…”

Hypoxemia during One-lung Ventilation

“…60,61 During OLV, any strengthening of HPV may further reduce perfusion of the nonventilated lung and improve oxygenation. In one study, 62 the authors administered 16 g ⅐ kg Ϫ1 ⅐ min Ϫ1 almitrine (in combination with nitric oxide) during OLV and demonstrated a greater than 130% increase in PaO 2 . A more recent study has also used lower doses of almitrine with nitric oxide with similar results.…”

New Developments in Thoracic Anesthesia

“…75 As NO distributes directly into the alveoli, it is a selective microvasodilator only of those capillaries adjacent to ventilated alveoli, and therefore improve V/Q matching. 78,79 These results may be important for patients with a marginal respiratory reserve who are unable to maintain oxygenation on OLV. There was no beneficial effect of NO in the absence of hypoxemia, pulmonary vasoconstriction, and elevated pulmonary pressure during OLV.…”