Abstract
Pulmonary hypertension (PAH) is a life-threatening disease commonly seen in ICU septic patients. PAH is characterized by alterations in the pulmonary circulation leading to right ventricular failure and is associated with poor outcome in such patients. Various agents such as nitric oxide, prostaglandins and phosphodiesterase inhibitors have been used for its treatment. Drugs that induce pulmonary vasodilatation, increase contractility and maintain a stable haemodynamic profile seem an attractive treatment option in acute PAH patients. However, there is lack of evidence-based guidelines in the current medical literature. Although oral diltiazem has been shown to improve haemodynamics in chronic PAH patients, it has not been used for the treatment of acute PAH. The aim of the present study was to evaluate the effects of intravenous diltiazem on a porcine model of acute PAH during sepsis.
Highlights
There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient’s experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients
In a logistic regression model, only sex and the dose/kg were significantly associated with the achievement of Cmax above 16 μg/ml
Results of this study show that early tracheostomy, if perioperative complications
Summary
There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient’s experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients. Conclusions Our data demonstrate that critically ill patients may be exposed to a higher FiO2 than that required to maintain adequate oxygenation These results highlight an area of ICU care that has received little study, with no published clinical trials examining the effect of FiO2 on outcome. Results Age, sex, the underlying disease and tumour stage (TNM classification), type of previous anticancer treatment, performance status, severity scores (APACHE II, Simplified Acute Physiology Score II, Sequential Organ Failure Assessment), ICU and hospital mortalities and hospital outcome at 3, 6 and 12 months were analysed. Clinical data of 277 post-transplantation patients admitted to the ICU were collected at admission and the SAPS 3 and APACHE II score calculated with respective estimated mortality rates.
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