This study confirms that intravenous almitrine greatly improves arterial oxygenation in patients with acute lung injury but may also induce lactic acidosis and hepatic dysfunction. (silverchair.com)
Almitrine, a selective pulmonary vasoconstrictor in hypoxic area, improves oxygenation in mechanically ventilated patients with COVID-19 but its effects in spontaneously breathing patients with COVID-19 remain to be determined. (biomedcentral.com)
Almitrine could be an interesting therapy in spontaneously breathing patients with COVID-19 treated with HFNO and with persistent hypoxemia, given its effects on oxygenation without serious adverse effects regardless of the CT-Scan pattern, and potentially on intubation rate. (biomedcentral.com)
The first aim of this study was to assess the effects of almitrine on oxygenation in spontaneously breathing patients with severe pneumonia related to SARS-CoV-2 pneumonia treated with high-flow nasal cannula oxygen therapy (HFNO) and with persistent hypoxemia. (biomedcentral.com)
The second aim was to assess the effects of almitrine on oxygenation according to the thoracic CT-Scan patterns. (biomedcentral.com)
Selective1
In phenylephrine-responsive patients, phenylephrine augments the improvement in PaO2 seen with inhaled NO. These results may reflect selective enhancement of hypoxic pulmonary vasoconstriction by phenylephrine, which complements selective vasodilation by NO. (asahq.org)
Hypertension2
Adult respiratory distress syndrome (ARDS) is a syndrome with diverse causes, characterized by profound hypoxemia, pulmonary hypertension, and poor lung compliance. (asahq.org)
[2,3] In addition, the association of weight loss and worsening pulmonary hypertension has reduced considerably the use of almitrine for the long-term treatment of patients with chronic obstructive pulmonary disease. (silverchair.com)
Arterial1
Intravenous almitrine increased the ratio of arterial oxygen pressure to inspiratory oxygen fraction from 93 +/- 33 mmHg to 207 +/- 107 mmHg (mean +/- SD). (silverchair.com)
Results1
In this group of patients, the total bilirubin concentration was elevated before almitrine administration, and the results of other hepatic function tests, such as aspartate aminotransferase, alanine aminotransferase, and prothrombin time, were altered by almitrine administration. (silverchair.com)
Administration1
Univariate and multivariate analyses revealed that an abnormal plasma concentration of total bilirubin before almitrine administration and female gender were the two factors significantly linked with lactic acidosis during almitrine infusion. (silverchair.com)
Patients3
The coexistence of lactic acidosis and hepatic dysfunction in the same patients strongly suggests that the liver is the primary source of intravenous almitrine-induced lactic acidosis. (silverchair.com)
ORAL almitrine bismesylate has been used for many years to improve gas exchange in patients with chronic obstructive pulmonary disease. (silverchair.com)
We included all patients over 18 years old admitted to ICU for SARS-CoV-2 pneumonia treated with HFNO and with persistent hypoxemia from January 2021 (start of the use of almitrine in our ICU for patients with COVID-19) to January 2022. (biomedcentral.com)