Abstract
Chronic hypoxemia following long lasting bronchial obstruction in adolescent C/F is a new problem since improved survival. Serious disconfort as headache, loss of intellectual fitness and even cor pulmonale results. As chronic oxygen therapy is mostly not accepted in mild cases we looked for almitrine, a proven peripheral chemo-receptor aganist, which has been shown efficient in old patients with COPD. It was given to 5 patients with a mean age of 15 years. Before and 20 min after IV almi-trine (0.25 mg/kg/h) gazometric, hemodynamic and lung mechanic parameters were measured and the distribution of ventilation-perfusion ratios were determined by the multiple inert gas elimination technique. During almitrine infusion oxygenation (pa O2 varied from 63.0±3.1 to 72.0 ± 2.5 mm Hg, p < 0.02) improved. Alveolar to arterial pO2 gradient (from 36.5 ± 3.3 to 30.8 ± 2.4 mmHg, p = 0.10) and venous admixture (from 19.0 ± 3.1 to 13.3 ± 1.6%, p = 0.07) decreased slightly. Pulmonary arterial mean pressure (from 20.3 ± 1.8 to 23.1 ± 1.7, p < 0.01) and pulmonary vascular resistance index (from 254 ± 13 to 300 ± 8 dyne.1 cm-5.m2, p < 0.02) increased significantly. Minute ventilation (from 8.2 ± 0.7 to 8.1 ± 0.6 1/min, N.S.) did not change. We conclude that almitrine increases arterial oxygenation in C/F by improvement of VA/Q matching. This improvement of gas exchange function of the lung appeared to be related to an increased vascular tone which was well tolerated. These preliminary results deserve to be confirmed by chronic oral treatment.
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Dab, I., Melot, C., Haltermans, R. et al. IMPROVED ARTERIAL OXYGENATION BY ALMITRINE IN CYSTIC FIBROSIS ADOLESCENTS. Pediatr Res 18, 800 (1984). https://doi.org/10.1203/00006450-198408000-00052
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DOI: https://doi.org/10.1203/00006450-198408000-00052