Abstract
The effects of nitroglycerin, dopamine and dobutamine on pulmonary gas exchange were determined in 21 adult patients during two-lung and one-lung ventilation. Nitroglycerin, in I μg·kg−1·min−1, decreased cardiac index (CI) andPaO2 during both two-and one-lung ventilation, and increased in Qs/Qt during one-lung ventilation. There were no significant changes in the measured variables during infusion of dopamine, 5 μg·kg−1·min−1. Dobutamine, 5μg·kg−1·min−1, increased Cl and PaO2 did not change during two-lung ventilation. During one-lung ventilation, PaO2 increased from (mean value ±SD) 168 ± 46 to 201 ± 52 mmHg (P < 0.01) with dobutamine infusion. Qs/Qt decreased from 29.2 ± 7.0 to 26.0 ± 6.2 per cent (P < 0.05) without any change in pulmonary vascular resistance index during one-lung ventilation. We conclude that dobutamine has advantages over dopamine and nitroglycerin during one-lung ventilation.
Résumé
Les auteurs ont mesuré chez 21 adultes, l’effet de la nitroglycérine, de la dopamine ou de la dobutamine sur les échanges gazeux en ventilation uniet bi-pulmonaire. A la dose de 1 μg·kg−1·min−1 la nitroglycerine diminuait l’index cardiaque (Cl) et la PaO2 tant en ventilation bi-qu’unipulmonaire alors qu’elle augmentait le Qs/Qt de ce dernier mode. Ces mimes variables sont demeurées inchangées par Iinfusion de 5μg·kg−1·min−1 de dopamine. La dobutamine, à raison de 5 μg·kg−1·min−1 ne modifia pas le Cl ni la PaO2 en ventilation bi-pulmonaire quoique avec elle, quand un seul poumon etait ventile, la PaO2 passait de 168 ± 46 a 201 ± 52 mmHg (P < 0.01) et le Qs/Qt de 29.2 ±0.7 a 26.0 ± 6.2 (P < 0.05) et ce, sans changement de l’index de résistance vasculaire pulmonaire. La supériorite de la dobutamine en ventilation uni-pulmonaire est ainsi etablie.
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Nomoto, Y., Kawamura, M. Pulmonary gas exchange effects by nitroglycerin, dopamine and dobutamine during one-lung ventilation in man. Can J Anaesth 36, 273–277 (1989). https://doi.org/10.1007/BF03010764
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DOI: https://doi.org/10.1007/BF03010764