ISSN:
1432-1238
Keywords:
Prostacyclin
;
Tissue oxygen delivery
;
Tissue oxygen consumption
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract We infused prostacyclin into 11 critically ill patients for 30 min at a rate of 5 ng/kg·min, prior to commencing prostacyclin haemodialysis. All patients had combined respiratory and renal failure and required intropic support. Despite the previous correction of hypovolaemia, prostacyclin produced a decrease in mean arterial pressure, pulmonary and systemic vascular resistances and cardiac filling pressures. There was no compensatory increase in cardiac output and due to an increase in pulmonary ventilation/perfusion mismatch an overall decrease in tissue oxygen delivery from a median of 560 ml/min·m2 to 370 ml/min·m2 was notedp〈0.05, with a corresponding reduction in tissue oxygen uptake from 140 ml/min·m2 to 125 ml/min·m2. This was associated with an increase in both arterial hydrogen ion and lactate concentrations in 8 of the 11 patients studied, suggesting a deterioration in tissue oxygen supply/oxygen requirement. Prostacyclin should not be infused directly into patients unless monitored to assess the therapeutic/adverse effects on an individual patient basis.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01711220
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