Influence of nimodipine and nifedipine on intrapulmonary shunting — a comparison to other vasoactive drugs

✍ Scribed by J. Boldt; B. v. Bormann; D. Kling; K. Ratthey; G. Hempelmann

• Book ID: 104690630
• Publisher: Springer
• Year: 1987
• Tongue: English
• Weight: 454 KB
• Volume: 13
• Category: Article
• ISSN: 1432-1238
• DOI: 10.1007/bf00263558

✦ Synopsis

This study was assigned to investigate the influence of calcium channel blockers (nimodipine and nifedipine) in comparison to other vasoactive drugs (nitroglycerin, dopamine) on pulmonary shunting (Qs/Qt). Fifty anesthetised patients scheduled for aortocoronary bypass operation were randomly allocated to 5 groups receiving one of the following drugs: nimodipine 1.0 microgram X kg-1 X min-1; nifedipine 0.7 microgram X kg-1 X min-1; nitroglycerin (TNG) 0.5 microgram X kg-1 X min-1; dopamine; micrograms X kg-1 X min-1; placebo (0.9% NaCl). Nimodipine as well as nifedipine led to a significant increase in cardiac output (+44%; +39%), pulmonary vascular resistance simultaneously decreased (-25%; -28%). PaO2 increased significantly (+16%; +13%), too, whereas Qs/Qt remained almost unchanged. In contrast, the increase in cardiac output induced by dopamine (+27%) was accompanied by a significant increase in shunting (+34%). TNG application did not alter Qs/Qt, but pulmonary artery pressure (PAP) decreased markedly (-19%).