Treatment of Hypoxemia During One-Lung Ventilation Using Intravenous Almitrine

Abstract

IV almitrine improves oxygenation during one-lung ventilation without hemodynamic modification. Such treatment could be used when conventional ventilatory strategy fails to treat hypoxemia or cannot be used.

Effects of propofol vs sevoflurane on arterial oxygenation during one-lung ventilation

“…Transoesophageal Doppler is not appropriate as a characteristic aortic blood flow signal cannot be obtained in half of the patients in similar conditions. 24 Consequently, we could not have any access to cardiac output evaluation. However, requirements for ephedrine, heart rate, and mean arterial pressure were similar between the two groups.…”

Compressing the non-dependent lung during one-lung ventilation improves arterial oxygenation, but impairs systemic oxygen delivery by decreasing cardiac output

“…Despite treatment with nitric oxide [3], prostaglandin E1 [4], prostaglandin F2 alpha [5], almitrine [6], or different anesthetic drugs [7][8][9][10], hypoxemia during OLV can remain a problem.…”

Low- vs high-dose almitrine combined with nitric oxide to prevent hypoxia during open-chest one-lung ventilation

“…Length of hospital stay was 15 (10), 17 (11) and 12 (3) days for the placebo, ALM4+NO and ALM16+NO groups respectively, and intrahospital mortality was 0/14, 1/14 and 0/14 respectively. No clinical signs of Silva-Costa-Gomes et al (8) polyneuropathy were observed in any patient at the time of discharge.…”

“…[3][4][5] Almitrine enhances hypoxic pulmonary vasoconstriction (HPV) in non-ventilated lung units, while iNO dilates pulmonary vessels from the ventilated areas. Regarding OLV, only one group of investigators demonstrated that almitrine alone or combined with iNO improved hypoxia, [6][7][8] but the optimal dose of almitrine, combined with iNO during open-chest OLV, that would provide improvement in oxygenation with minimal sideeffects is unknown. The present investigation was designed to address this issue.…”