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Báo cáo y học: " Nitroglycerin can facilitate weaning of difficult-to-wean chronic obstructive pulmonary disease patients: a prospective interventional non-randomized study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Nitroglycerin can facilitate weaning of difficult-to-wean chronic obstructive pulmonary disease patients: a prospective interventional non-randomized study. | Routsi et al. Critical Care 2010 14 R204 http ccforum.eom content 14 6 R204 c CRITICAL CARE RESEARCH Open Access Nitroglycerin can facilitate weaning of difficult-to-wean chronic obstructive pulmonary disease patients a prospective interventional non-randomized study 1 2 1 11 Christina Routsi loannis Stanopoulos Epaminondas Zakynthinos Panagiotis Politis Vassilios Papas Demetrios Zervakis 1 Spyros Zakynthinos1 Abstract Introduction Both experimental and clinical data give convincing evidence to acute cardiac dysfunction as the origin or a cofactor of weaning failure in patients with chronic obstructive pulmonary disease. Therefore treatment targeting the cardiovascular system might help the heart to tolerate more effectively the critical period of weaning. This study aims to assess the hemodynamic respiratory and clinical effects of nitroglycerin infusion in difficult-to-wean patients with severe chronic obstructive pulmonary disease. Methods Twelve difficult-to-wean failed 3 consecutive trials chronic obstructive pulmonary disease patients who presented systemic arterial hypertension systolic blood pressure 140mmHg during weaning failure and had systemic and pulmonary artery catheters in place participated in this prospective interventional nonrandomized clinical trial. Patients were studied in two consecutive days i.e. the first day without Control day and the second day with Study day nitroglycerin continuous intravenous infusion starting at the beginning of the spontaneous breathing trial and titrated to maintain normal systolic blood pressure. Hemodynamic oxygenation and respiratory measurements were performed on mechanical ventilation and during a 2-hour T-piece spontaneous breathing trial. Primary endpoint was hemodynamic and respiratory effects of nitroglycerin infusion. Secondary endpoint was spontaneous breathing trial and extubation outcome. Results Compared to mechanical ventilation mean systemic arterial pressure rate-pressure product mean pulmonary .