Update 1991 pp 306-309 | Cite as

Vasodilating Therapy in ARDS

  • P. Radermacher
  • B. Santak
Conference paper
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 14)


In patients suffering from the adult respiratory distress syndrome (ARDS), pulmonary hypertension is common event [1] and has been directly related to the severity of the lung injury [2]. This pulmonary hypertension is due to an increased pulmonary vascular resistance [1] which is caused by vascular compression [2], diffuse vasoconstriction [2] and microvascular obstruction [3].


Pulmonary Hypertension Pulmonary Artery Pressure Acute Respiratory Failure Adult Respiratory Distress Syndrome Microvascular Obstruction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Zapol WM, Snider MT (1977) Pulmonary hypertension in severe acute respiratory failure. N Engl J Med 296:476–480PubMedCrossRefGoogle Scholar
  2. 2.
    Zapol WM, Jones R (1987) Vascular components of ARDS. Am Rev Respir Dis 136:471–474PubMedCrossRefGoogle Scholar
  3. 3.
    Greene RD, Zapol WM, Snider MT, et al. (1981) Early bedside detection of pulmonary vascular occlusion during acute respiratory failure. Am Rev Respir Dis 124:593–601PubMedGoogle Scholar
  4. 4.
    Brigham KL, Woolverton WC, Blake LH, Staub NC (1974) Increased sheep lung vascular permeability caused by Pseudomonas bacteremia. J Clin Invest 54:792–804PubMedCrossRefGoogle Scholar
  5. 5.
    Sibbald WJ, Driedger AA, Myers ML, Short AIK, Wells GA (1983) Biventricular function in the adult respiratory distress syndrome. Chest 84:126–134PubMedCrossRefGoogle Scholar
  6. 6.
    Jardin F, Farcot JC, Boisante L, Curien N, Margairaz A, Bourdarias JP (1981) Influence of positive end-expiratory pressure on left ventricular performance. N Engl J Med 304:387–392PubMedCrossRefGoogle Scholar
  7. 7.
    Sibbald WJ, Driedger AA, McCallum DM, Cunningham DG, Cheung H (1986) Nitroprus-side infusion does not improve biventricular performance in patients with acute hypoxemic respiratory failure. J Crit Care 1:197–203CrossRefGoogle Scholar
  8. 8.
    Sibbald WJ, Short AIK, Driedger AA, Wells GA (1985) The immediate effect of isosorbide dinitrate on right ventricular function in patients with acute hypoxemic respiratory failure. Am Rev Respir Dis 131:852–868Google Scholar
  9. 9.
    Radermacher P, Santak B, Wüst HJ, Tarnow J, Falke KJ (1990) Prostacyclin and right ventricular function in patients with pulmonary hypertension associated with ARDS. Intensive Care Med 16:227–232PubMedCrossRefGoogle Scholar
  10. 10.
    Grimbert FA (1988) Effective pulmonary capillary pressure. Eur Respir J 1:297–301PubMedGoogle Scholar
  11. 11.
    Gaar KA, Taylor AE, Owens LJ, Guyton AC (1967) Pulmonary capillary pressure and filtration coefficient in the isolated perfused lung. Am J Physiol 213:910–914PubMedGoogle Scholar
  12. 12.
    Collee GG, Lynch KE, Hill RD, Zapol WM (1987) Bedside measurement of pulmonary capillary pressure in patients with acute respiratory failure. Anesthesiology 66:614–620PubMedCrossRefGoogle Scholar
  13. 13.
    Radermacher P, Santak B, Becker H, Falke KJ (1989) Prostaglandin El and nitroglycerin reduce pulmonary capillary pressure but worsen VA/Q distributions in patients with ARDS. Anesthesiology 70:601–606PubMedCrossRefGoogle Scholar
  14. 14.
    Prewitt RM, McCarthy J, Wood LDH (1981) Treatment of acute low pressure pulmonary edema in dogs. J Clin Invest 67:409–418PubMedCrossRefGoogle Scholar
  15. 15.
    Gottlieb SS, Wood LDH, Hansen DE, Long R (1987) The effect of nitroprusside on pulmonary edema, oxygen exchange, and blood flow in hydrochloric acid aspiration. Anesthesiology 67:203–210PubMedCrossRefGoogle Scholar
  16. 16.
    Gattinoni L, Pesenti A, Bombino M, et al. (1988) Relationships between lung compute tomographic density, gas exchange, and PEEP in acute respiratory failure. Anesthesiology 69:824–832PubMedCrossRefGoogle Scholar
  17. 17.
    Radermacher P, Santak B, Wüst HJ, Tarnow J, Falke KJ (1990) Prostacyclin for the treatment of pulmonary hypertension in the adult respiratory distress syndrome: effects on pulmonary capillary pressure and ventilation-perfusion distributions. Anesthesiology 72:238–244PubMedCrossRefGoogle Scholar
  18. 18.
    Perlman MB, Lo SK, Malik AB (1986) Effect of prostacyclin on pulmonary vascular response to thrombin in awake sheep. J Appl Physiol 60:546–553PubMedGoogle Scholar
  19. 19.
    Mélot C, Naeije R, Mols P, Hallemans R, Lejeune P, Jaspar N (1987) Pulmonary vascular tone improves pulmonary gas exchange in the adult respiratory distress syndrome. Am Rev Respir Dis 136:1232–1236PubMedCrossRefGoogle Scholar
  20. 20.
    Radermacher P, Huet Y, Pluskwa F, et al. (1988) Comparison of ketanserin and sodium nitroprusside in patients with severe ARDS. Anesthesiology 68:152–157PubMedCrossRefGoogle Scholar
  21. 21.
    Mélot C, Lejeune P, Leeman M, Moraine JJ, Naeije R (1989) Prostaglandin El in the adult respiratory distress syndrome. Am Rev Respir Dis 139:106–110PubMedCrossRefGoogle Scholar
  22. 22.
    Lynch JP, Mhyre JG, Dantzker DR (1979) Influence of cardiac output on intrapulmonary shunt. J Appl Physiol 46:315–322PubMedGoogle Scholar
  23. 23.
    Breen PH, Schumacker PT, Hedenstierna G, Ali J, Wagner PD, Wood LDH (1982) How does increased cardiac output increase shunt in pulmonary edema? J Appl Physiol 53:1273–1280PubMedCrossRefGoogle Scholar
  24. 24.
    Domino KB, Wetstein L, Glassner SA, et al. (1983) Influence of mixed venous oxygen tension (PvO2ood flow to atelectatic lung. Anesthesiology 59:428–434PubMedCrossRefGoogle Scholar
  25. 25.
    Naeije R, Mélot C, Mols P, Hallemans R (1982) Effects of vasodilators on hypoxic pulmonary vasoconstriction in normal man. Chest 82:404–410PubMedCrossRefGoogle Scholar
  26. 26.
    Sprague RS, Stephenson AH, Lonigro AJ (1984) Prostaglandin 12 supports blood flow to hypoxic alveoli in anesthetized dogs. J Appl Physiol 56:1246–1251PubMedGoogle Scholar
  27. 27.
    Bihari D, Smithies M, Gimson A, Tinker J (1987) The effects of vasodilation with prostacyclin on oxygen delivery and uptake in critically ill patients. N Engl J Med 317:397–403PubMedCrossRefGoogle Scholar
  28. 28.
    Schumacker PT, Cain SM (1987) The concept of critical oxygen delivery. Intensive Care Med 13:223–229PubMedCrossRefGoogle Scholar
  29. 29.
    Kariman K, Burns SR (1985) Regulation of tissue oxygen extraction is disturbed in adult respiratory distress syndrome. Am Rev Respir Dis 132:109–114PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin, Heidelberg 1991

Authors and Affiliations

  • P. Radermacher
  • B. Santak

There are no affiliations available

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