nitroglycerin pulmonary hypertension
Published by Elsevier Ltd. All rights reserved. The effect of acetylcholine on the human pulmonary circulation under normal and hypoxic conditions. Buckley MS, Feldman JP. Anh ch hy lm sng t kin trn qua on trch:Trc mun trng sng b. Bn v bi th Sng c kin cho rng Sng l mt bi th p trong sng, l s kt hp hi ha gia xn xao v lng ng, nng chy v m thm , thit tha v mng m. var D=new Date(),d=document,b='body',ce='createElement',ac='appendChild',st='style',ds='display',n='none',gi='getElementById'; Many community hospitals and some of tertiary care facilities in the USA have no access to these treatment modalities. 18investigated the effects of nitroglycerin inhalation in PHT resulting from congenital cardiac defects and reported decreases in systolic pulmonary artery pressure and mean pulmonary artery pressure as a result of nitroglycerin administration; however, heart rate, systolic arterial pressure, and mean arterial pressure were not affected. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username. Oral hydralazine therapy for primary pulmonary hypertension. Unfavorable hemodynamic and clinical effects of isoproterenol in primary pulmonary hypertension. Nineteen children with acyanotic congenital heart disease and a left to right shunt with severe PAH, undergoing routine diagnostic cardiac catheterization were included in this study. Combination therapy with oral sildenafil and inhaled iloprost for severe pulmonary hypertension. If the address matches an existing account you will receive an email with instructions to reset your password. On the contrary, this patient also improved her pulmonary haemodynamics and resolved shock within 1012 hours without any effect on the oxygen saturation and without a rebound phenomenon. The patient was stabilised sufficiently for transfer to a tertiary care centre. var s=iw[ce]('script');s.async='async';s.defer='defer';s.charset='utf-8';s.src="//jsc.mgid.com/v/a/vanmauchonloc.vn.219228.js?t="+D.getYear()+D.getMonth()+D.getUTCDate()+D.getUTCHours();c[ac](s);})(); Phn tch nhn vt Tn trong truyn ngn Rng x nu, Anh ch hy son bi Nguyn nh Chiu Ngi sao sng vn ngh ca dn tc ca Phm Vn ng, Quan im ngh thut ca nh vn Nguyn Minh Chu, Anh ch hy son biVit Bc ca tc gi T Hu, Anh ch hy son bi Ai t tn cho dng sng ca tc gi Hong Ph Ngc Tng, Trong thin truyn Nhng a con trong gia nh ca nh vn Nguyn Thi c mt dng sng truyn thng gia nh lin tc chy. 1998;65(1):63-70. Son bi Tuyn ngn c lp ca Ch tch H Ch Minh. Frostell CG et al. In these cases, patients require transfer to a pulmonary hypertension centre. The hemodynamic effects of nitroglycerin in human pulmonary hypertension are not known. This content is PDF only. Copyright 2006 British Journal of Anaesthesia. Systolic, diastolic and mean pulmonary artery pressure and PVRI decreased significantly, whereas heart rate, systolic, diastolic and mean systemic arterial pressure, PCWP and SVRI did not change significantly following 100% oxygen or inhalation of nitroglycerin. Deleterious effects of hydralazine in patients with pulmonary hypertension. Ann Thorac Cardiovasc Surg. Table 2: Haemodynamic parameters starting from the time pulmonary artery catheter was inserted. ScienceDirect is a registered trademark of Elsevier B.V. ScienceDirect is a registered trademark of Elsevier B.V. Efficacy of nitroglycerin inhalation in reducing pulmonary arterial hypertension in children with congenital heart disease, complications, pulmonary arterial hypertension. Hamilton, BC Decker, 1999, pp 33546, Clutton-Brock J: Two cases of poisoning by contamination of nitrous oxide with higher oxides of nitrogen during anaesthesia. In addition to the limited evidence for the use of inhaled nitroglycerine, nitroglycerine may also cause methemoglobinaemia as a result of the production of nitric oxide molecules and oxidised species. W V Med J 1999; 95: 745, Bando M, Ishii Y, Kitamura S, Ohno S: Effects of inhalation of nitroglycerin on hypoxic pulmonary vasoconstriction. 
The same study concluded that inhaled iloprost was likely more effective than inhaled nitroglycerine.12 The greatest benefits, therefore, in the use of inhaled nitroglycerine compared iloprost are in cost and availability, as nitroglycerine is available in nearly all acute medical settings, it is substantially cheaper in comparison to iloprost. All Rights Reserved. Circulation 1981; 63: 8795, Van Obbergh LJ, Charbonneau M, Blaise G: Combination of inhaled nitric oxide with i. v. nitroglycerin or with a prostacyclin analogue in the treatment of experimental pulmonary hypertension. Br J Anaesth 1996; 77: 22731, Girard C, Lehot JJ, Pannetier JC, Filley S, Ffrench P, Estanove S: Inhaled nitric oxide after mitral valve replacement in patients with chronic pulmonary artery hypertension. International edition, New York, McGraw-Hill, 2001, pp 160723, Bave AE, Geha AS, Hammond GL, Laks H, Naunheim KS: Acquired disease of the mitral valve, Glenn's Thoracic and Cardiovascular Surgery, 6th edition. The reduction of the pulmonary artery pressure was dramatic, more than 50% in 6 hours, peaked at 6 hours with stepwise reduction, and no reduction in systemic arterial pressure occurred. Thus, it can be used as alternative mode of therapy in patients with PHT associated with mitral valve diseases. 2004;109(25):3106-11. 
Deceased, Professor, Department of Anesthesiology and Reanimation, Attending Surgeon, Department of Cardiovascular Surgery.
Both patients were treated with sildenafil, a phosphodiesteraseType 5inhibitor, in addition to inhaled nitroglycerine. Pulmonary vascular resistance decreased more than 25% in eight of the nine patients. 
Effect of glyceryl trinitrate on pulmonary vasculature of anesthetized dogs. Pediatr Int 2000; 42: 2558, Schmid ER, Burki C, Engel MH, Schmidlin D, Tornic M, Seifert B: Inhaled nitric oxide versus intravenous vasodilators in severe pulmonary hypertension after cardiac surgery. During the insertion of femoral dialysis catheter, the patient developed a large retroperitoneal haematoma and unfortunately died from haemorrhagic shock. From the Departments of Medicine and Anesthesia, Stanford University Medical Center; Stanford. Effect of nitroglycerin on pulmonary vascular resistance in the newborn puppy. Circulation. Pepke-Zaba J et al. 2002;136(7):515-22. NEJM. Similarly, milrinone used in the second case may also be considered as a confounding variable because of its ability to also promote vasodilation and improve contractility. Ichinose F et al. var D=new Date(),d=document,b='body',ce='createElement',ac='appendChild',st='style',ds='display',n='none',gi='getElementById',lp=d.location.protocol,wp=lp.indexOf('http')==0?lp:'https:'; We administered nitroglycerin to nine patients with chronic pulmonary hypertension. In conclusion, nitroglycerin inhalation decreases mean pulmonary artery pressure, pulmonary vascular resistance, and Qs/Qt ratio without affecting heart rate, mean arterial pressure, central venous pressure, pulmonary capillary wedge pressure, systemic vascular resistance, or cardiac output after mitral valve replacement surgery. Br J Anaesth. Inhaled nitric oxide as a cause of selective pulmonary vasodilation in pulmonary hypertension. Prostacyclin-induced acute pulmonary vasodilation in primary pulmonary hypertension. We'll assume you're ok with this, but you can opt-out if you wish. Four days later the patient had persistent renal failure that required dialysis. In a community hospital setting and in cases of life-threatening right heart failure and shock not responding to simple traditional treatments, thought should be given to the use of inhaled nitroglycerine. Therapy of pulmonary hypertension is limited by the low potency and adverse effects of current pulmonary vasodilators. var i=d[ce]('iframe');i[st][ds]=n;d[gi]("M322801ScriptRootC264914")[ac](i);try{var iw=i.contentWindow.document;iw.open();iw.writeln("
Diazoxide in primary pulmonary hypertension. catch(e){var iw=d;var c=d[gi]("M322801ScriptRootC219228");}var dv=iw[ce]('div');dv.id="MG_ID";dv[st][ds]=n;dv.innerHTML=219228;c[ac](dv); Reduction of pulmonary hypertension by nitroprusside. Care must be taken to monitor and evaluate these patients for this condition. This review has several limitations. Inhaled nitric oxide versus intravenous vasodilators in severe pulmonary hypertension after cardiac surgery. Ricciardi MJ et al. Systolic, diastolic and mean systemic as well as pulmonary artery pressures, right atrial pressure and pulmonary capillary wedge pressure (PCWP) were recorded and systemic vascular resistance index (SVRI) and pulmonary vascular resistance index (PVRI) were calculated at room air, following 100% oxygen as well as after nitroglycerin inhalation in all patients. Effects of sublingual nitroglycerin on resting pulmonary gas exchange and hemodynamics in man. Vasodilator therapy for heart failure: the influence of impedance on left ventricular performance. High mortality rates are accentuated by a lack of diagnosis or the non-availability of treatment. J Thorac Cardiovasc Surg 1996; 111: 75363, Gong F, Shiraishi H, Kikuchi Y, Hoshina M, Ichihashi K, Sato Y, Momoi MY: Inhalation of nebulized nitroglycerin in dogs with experimental pulmonary hypertension induced by U46619. A nesthesiology 1992; 77: 8803, Fullerton DA, Jones SD, Jaggers J, Piedalue F, Grover FL, McIntyre RC Jr: Effective control of pulmonary vascular resistance with inhaled nitric oxide after cardiac operation.
Inhaled nitroglycerine is practical, likely to be predictable, cheap, readily available in any hospital, and does not require reconstitution. J Am Coll Cardiol. Respir Med. In addition, inhalation of nitroglycerin increases the Pao2/Fio2ratio. Certainly, a clinical trial would be helpful to shed light on more potential side effects, the presence or absence of a rebound phenomenon, duration of effect, and head-to-head comparison to other therapy. We investigated the acute effects of inhaled nitroglycerin on pulmonary and systemic haemodynamics in children with PAH associated with congenital heart disease. This website uses cookies to improve your experience. Dramatic rapid reduction in pulmonary arterial pressure was noted with a decrease in pressor requirements. Primary pulmonary hypertension treated with oral phentolamine. 2004;351(16):1655-65. Ghofrani HA et al. Here, two cases of pulmonary hypertension and acute right heart failure that responded favourably to inhaled nitroglycerine are reported. This patient is even more interesting because an inhaled agent that vasodilates pulmonary arties may have increased blood flow through pulmonary venules and increased the left heart end diastolic volume (and pressure, implicitly). Search for other works by this author on: Vlahakes GJ, Turley K, Hoffman JI: The pathophysiology of failure in acute right ventricular hypertension: Hemodynamic and biochemical correlations. Copyright 2022 European Medical Group LTD trading as European Medical Journal. Copyright 2022 American College of Physicians. Partial reversibility of chronic pulmonary hypertension caused by pulmonary thromboembolic disease. European Medical Journal is for informational purposes and should not be considered medical advice, diagnosis or treatment recommendations. Hy by t kin ca mnh, Nh vn khng c php thn thng vt ra ngoi th gii nay. Intravenous nitroglycerin: a review of pharmacology, indications, therapeutic effects and complications. Approximately 12 hours later, the patient was completely weaned off noradrenaline. Omar et al.
1998;12:265-70. Circulation. The same doses of nitroglycerin infusion did not decrease mean pulmonary artery pressure but decreased mean arterial pressure. C trong m cn thc. 1999;89(5):1108-15. This approach will allow for treatment of shock or at least temporary stabilisation until the patient is transferred to a tertiary care facility. Respiration 1998; 65: 6370, This site uses cookies. nhn xt v ci nhn thin nhin ca mi nh th, Anh ch hy lin h v so snh hai tc phm Vit Bc v T y, Anh ch hy lin h v so snh 2 tc phm y thn V D v Sng Hng. They concluded that inhalation of nitroglycerin is more effective in pulmonary circulation when compared to nitroglycerin infusion. Br J Anesth 1967; 39: 38892, Rossaint R, Falke KJ, Lopez F, Slama K, Pison U, Zapol WM: Inhaled nitric oxide for the adult respiratory distress syndrome. J Am Coll Cardiol. Adverse hemodynamic effects of phentolamine in primary pulmonary hypertension. 2006;12(5):319-23. Effects of prostaglandin El on pulmonary circulation in patients with pulmonary hypertension. Their cost is often prohibitive. Edited by Swain JA. min1decreased mean arterial pressure, mean pulmonary artery pressure, and pulmonary vascular resistance but did not affect cardiac output. Effects of inhaled nitroglycerine on hypoxic pulmonary vasoconstriction. Because mean arterial pressure was not affected by the doses used in this study, we assume that nitroglycerin acts as a venodilator at this dose, but in this study design, it is not possible to predict the exact dose reaching the distal lung. Anesthesia Analgesia. 2006;97(2):208-14. By continuing you agree to the use of cookies. The rapid improvement of these patients following inhaled nitroglycerine administration makes the improvement unlikely to be a result of sildenafil alone; nevertheless, sildenafil would be considered a confounding variable because of its promotion of pulmonary vasodilation and lack of controls in this review. Goyal P et al. Right ventricular unloading: lessons from the left [Editorial]. The patient was transferred to tertiary care centre for chronic management of pulmonary hypertension. Inhaled nitric oxide: a selective pulmonary vasodilator: current uses and therapeutic potential.
Primary pulmonary hypertension: effects of nifedipine. Son Bi Chic Lc Ng Ng Vn 9 Ca Nh Vn Nguyn Quang Sng, Nt c Sc Ngh Thut Trong hai a Tr Ca Thch Lam, Phn Tch V p Ca Sng Hng Qua Gc Nhn a L | Ai t Tn Cho Dng Sng, Tm Tt Truyn Ngn Hai a Tr Ca Thch Lam, Cm nhn v nhn vt b Thu trong tc phm Chic lc ng ca Nguyn Quang Sng, Tm tt tc phm truyn ngn Bn Qu ca nh vn Nguyn Minh Chu, Tm Tt Chuyn Ngi Con Gi Nam Xng Lp 9 Ca Nguyn D, Ngh Thut T Ngi Trong Ch Em Thy Kiu Ca Nguyn Du, Nu B Cc & Tm Tt Truyn C B Bn Dim Ca An c Xen, Hng Dn Son Bi Ti i Hc Ng Vn 8 Ca Tc Gi Thanh Tnh, Vit Mt Bi Vn T Cnh p Qu Hng Em, Vit Mt Bi Vn T Mt Cnh p Qu Hng M Em Yu Thch, Mt ngy so vi mt i ngi l qu ngn ngi, nhng mt i ngi li do mi ngy to nn (Theo nguyn l ca Thnh Cng ca nh xut bn vn hc thng tin). We conclude that therapy with nitroglycerin can be effective in patients with severe pulmonary hypertension.
Cm nhn v p on th sau: Ngi i Chu Mc chiu sng y.Tri dng nc l hoa ong a (Trch Ty Tin Quang Dng) t lin h vi on th Gi theo li gi my ng my.C ch trng v kp ti nay? (Trch y Thn V D).
Clinical value of vasodilator test with inhaled nitric oxide for predicting long-term response to oral vasodilators in pulmonary hypertension. Therefore, further randomized trials are needed. catch(e){var iw=d;var c=d[gi]("M322801ScriptRootC264914");}var dv=iw[ce]('div');dv.id="MG_ID";dv[st][ds]=n;dv.innerHTML=264914;c[ac](dv); Inhaled nitroglycerine was started at a concentration of 200 g/mL and the patient was nebulised using large volume nebuliser set at an O2 delivery rate of 6 L/min. JAMA 1979; 242: 286971, Omar HA, Gong F, Sun MY, Einzig S: Nebulized nitroglycerin in children with pulmonary hypertension secondary to congenital heart disease. Recent studies in primary pulmonary hypertension including pharmacodynamic observations on pulmonary vascular resistance. Anh ch hy lm sng t v p ca dng sng truyn thng y qua cc nhn vt chnh trong tc phm, Anh ch hy nu cm nhn v hnh tng Rng x nu, Anh ch hy son bi t ncca tc gi Nguyn nh Thi, Anh ch hy son bi ng gi v bin c ca tc gi H minh u, Anh ch hy son bi Sngca tc gi Xun Qunh, Anh ch hy son bi Ch ngi t t ca tc gi Nguyn Tun, Cm nhn v nhn vt Tn trong truyn ngn Rng X Nu ca nh vn Nguyn Trung Thnh, Anh ch hy son bi Chic thuyn ngoi xa ca tc gi Nguyn Minh Chu, Nu cm nhn v hnh tng ngi n b lng chi trong tc phm Chic thuyn ngoi xa ca Nguyn Minh Chu, Phn tch im ging v khc nhau ca hai nhn vt Vit V Chin trong truyn ngn Nhng a con trong gia nh ca nh vn Nguyn Thi. Case Report: Inhaled Nitroglycerine as an Alternative to Inhaled Nitric. Pulmonary arterial hypertension. Eur Respir J. (adsbygoogle = window.adsbygoogle || []).push({}); (function(){ In a study of 100 adult patients with pulmonary hypertension undergoing mitral valve surgery, inhaled nitroglycerine 20 g/kg inhalation and iloprost 2.5 g/kg inhalation, both effectively reduced mean pulmonary artery pressure, pulmonary vascular resistance without affecting mean arterial pressure, systemic vascular resistance, and cardiac output. The authors speculate that her significant acute improvement in pulmonary haemodynamics with nebulised nitroglycerine, coupled with improvement in her oxygenation, was due to preferential vasodilation of pulmonary capillaries exchanging with ventilated areas alveolar units. J Thorac Cardiovasc Surg 1984; 88: 23847, Fuster V, Alexander RW, O'Rouke RA, Roberts R, King SB III, Hein JJ, Wellens HJJ: Pulmonary hypertension, Hurst's The Heart, 10th edition. This can be regarded as a drawback of our study. Pulmonary capillary wedge pressure was unobtainable (Table 2). Sildenafil in combination with inhaled iloprost has been shown to be effective in the treatment of severe pulmonary hypertension, possibly working together synergistically to increase nitric oxide levels and promote vasodilation.13 In theory, the authors believe that inhaled nitroglycerine may have the same synergistic effect with sildenafil. 2004;98(3):225-34. Stamford, Appleton and Lange, 1996, pp 194359, Franco KL, Verrier ED: Inhaled nitric oxide in heart and lung surgery, Advanced Therapy in Cardiac Surgery, 1st edition. There has been a renewed interest in nitric oxide donor drugs, such as nitroglycerin, delivered by the inhalational route for treatment of pulmonary arterial hypertension (PAH). To continue reading please click on the PDF icon. cm5, pulmonary artery pressure of 94/28. We use cookies to help provide and enhance our service and tailor content and ads. Respiration. Combined effects of nitric oxide and oxygen during acute pulmonary vasodilator testing. Blood pressure was stable even after stopping inhaled nitroglycerine. To receive the EMJ updates straight to your inbox free of charge, please click the button below. Ann Thorac Surg 1988; 45: 1336, Foltz BD, Hessel EA II, Ivey TD: The early course of pulmonary artery hypertension in patients undergoing mitral valve replacement with cardioplegic arrest. That resulted in the delivery of approximately 17 M (3.4 mg nitroglycerine) every 2 hours. 1998;32(4):1068-73. Factors that influence the outcome of primary pulmonary hypertension. 1991;338(8776):1173-4. It is known that at low doses, nitroglycerin acts as a venodilator, whereas at high doses it becomes an arteriodilator. Sitbom O et al. Edited by Rubin LJ. BI LM Please disclose any conflicts of interest or leave the box unchecked if you have none, Print ISSN: 0003-4819 | Online ISSN: 1539-3704, Annals of Internal Medicine: Clinical Cases, Author, Article, and Disclosure Information, Nitroglycerin inhalation for acute treatment of pulmonary arterial hypertension in children with congenital heart disease, Hypoxemia After Percutaneous Mitral Valve Replacement: Management, Hemodynamic Optimization Strategies in Anesthesia Care for Liver Transplantation, Management of acute and chronic RV dysfunction, Management of the Acutely Ill Patient with Pulmonary Arterial Hypertension, The Acute Hemodynamic Effect of IV Nitroglycerin and Dipyridamole in Patients With Pulmonary Arterial Hypertension: Comparison With IV Epoprostenol, Right ventricular diastolic performance: Compliance characteristics with focus on pulmonary hypertension, right ventricular hypertrophy, and calcium channel blockade, THERAPEUTIC OPTIONS FOR SEVERE PULMONARY HYPERTENSION, Primary Antiphospholipid Syndrome and Pulmonary Hypertension with Prolonged Survival, Inhaled nitric oxide as a screening vasodilator agent in primary pulmonary hypertension, Pulmonary vasodilator responses to nicardipine, Effects of glyceryl trinitrate (nitroglycerin) on pulmonary vascular pressures in standing Thoroughbred horses, Acute pulmonary hypertension complicating the arterial switch procedure, Pharmacotherapy of Chronic Pulmonary Arterial Hypertension: Value and Limitations, Paradoxic Pulmonary Vasoconstriction in Response to Acetylcholine in Patients With Primary Pulmonary Hypertension, Practical crisis management in the perioperative care of cardiac surgical patients, Intratracheal administration of pulmonary vasodilator agents, Mechanisms of action and efficacy of nitrates in heart failure, Care Following Surgical Treatment of Congenital Heart Disease, Vasodilating Drugs and Regional Circulation, Effects of Amrinone on Cardiac Index, Venous Oxygen Saturation and Venous Admixture in Patients Recovering from Cardiac Surgery, Prognostic and therapeutic considerations in clinicalprimary pulmonary hypertension, Cor Pulmonale in Chronic Obstructive Pulmonary Disease, Pulmonary Hypertension and Pregnancy A Lethal Combination, Cardiovascular-Pulmonary Interaction in Chronic Obstructive Pulmonary Disease with Special Reference to the Pathogenesis and Management of Cor Pulmonale, Primary pulmonary hypertension: diagnosis, medical and surgical treatment, Ventricular interaction in a canine model of acute pulmonary hypertension and its modulation by vasoactive drugs, Therapeutische Prinzipien bei pulmonaler Hypertonie und Cor pulmonale, The Pathophysiology and Management of Primary Pulmonary Hypertension, Pulmonary Vasodilator Therapy for Chronic Obstructive Pulmonary Disease and Cor Pulmonale, The acute effects of intravenous isosorbide dinitrate during cardiac surgery, Pulmonary hypertension in children: perioperative management, Cardiovascular alterations in severe pregnancy-induced hypertension: Effects of intravenous nitroglycerin coupled with blood volume expansion.
