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Jérémy Bourenne, Sami Hraiech, Romain Rambaud, Jean-Marie Forel, Nicolas Persico, Christophe Guervilly, Laurent Papazian
Acute respiratory distress syndrome (ARDS) commonly affects intensive care unit patients and is associated with high mortality. In addition to etiologic treatment and protective ventilation, non-ventilatory therapies represent a significant part of ARDS care. Pharmacological treatments, extra corporeal devices and prone positioning are commonly grouped under this term. Studies have evaluated the individual effects of some of these non- ventilatory therapies in large randomized controlled trials. Recent advances concerning the beneficial use of neuromuscular blocking agents and prone positioning deserve attention...
May 9, 2018: Minerva Anestesiologica
Pierre Esnault, Sami Hraiech, Julien Bordes, Jean-Marie Forel, Mélanie Adda, Romain Rambaud, Samuel Lehingue, Antoine Roch, Laurent Papazian, Christophe Guervilly
This single-center case series investigated the effect of almitrine infusion on PaO2/fraction of inspired oxygen (FIO2) in 25 patients on veno-venous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. A positive trial was defined as an increase of PaO2/FIO2 ratio ≥20%. Thirty-two trials were performed. Twenty (62.5%, 95% confidence interval, 37.5%-75%) trials in 18 patients were positive, with a median PaO2/FIO2 ratio increase of 35% (25%-43%). A focal acute respiratory distress syndrome and inhaled nitric oxide therapy were more frequent in patients with a positive response to almitrine...
January 15, 2018: Anesthesia and Analgesia
Diogo Mendes, Carlos Alves, Francisco Batel Marques
OBJECTIVE: To explore the usefulness of number needed to treat to be harmed (NNTH), in benefit-risk assessments, by studying the agreement between NNTH values and withdrawals of medicines from European market due to safety reasons. METHODS: Medicines with data from longitudinal studies were included. Studies were identified from European Medicines Agency's Reports. Meta-analyses were performed to pool odds ratios (OR) with 95% confidence-intervals (CI). Published control event rates were applied to ORs to calculate NNTHs (95%CI) for selected adverse events...
October 2016: Expert Opinion on Drug Safety
B Bouhemad, T Barbry, A Soummer, Q Lu, J J Rouby
BACKGROUND: Lung ultrasound can be used at bedside to assess initial lung morphology in hypoxemic patients. We hypothesized that blood flow in consolidated lung and therefore effects of inhaled nitric oxide (iNO) and intravenous almitrine could be directly assessed using Doppler transesophageal echocardiography (TEE). METHODS: We conducted a prospective study including 13 ALI patients with consolidated left lower lobe (LLL). Regional arterial and venous flow signals within the consolidation were recorded with TEE using Doppler at baseline, after iNO (5 ppm), almitrine (4 μg/kg/min) and their combination...
May 2014: Minerva Anestesiologica
Silvia Bermejo, Lluís Gallart, Teresa Silva-Costa-Gomes, Jordi Vallès, Rafael Aguiló, Margarita M Puig
OBJECTIVE: Almitrine enhances hypoxic pulmonary vasoconstriction (HPV) and can improve hypoxemia related to one-lung ventilation (OLV). Studies using almitrine have been conducted without inhaled anesthetics because they could inhibit HPV, counteracting the effect of almitrine. This hypothesis, however, has not been confirmed. This study's aim was to evaluate whether almitrine could improve oxygenation when administered during OLV with sevoflurane anesthesia. DESIGN: A prospective, randomized, double-blind, placebo-controlled trial...
August 2014: Journal of Cardiothoracic and Vascular Anesthesia
Francis J Golder, Matthew M Hewitt, James F McLeod
Drug-induced respiratory depression (DIRD) is a common problem encountered post-operatively and can persist for days after surgery. It is not always possible to predict the timing or severity of DIRD due to the number of contributing factors. A safe and effective respiratory stimulant could improve patient care by avoiding the use of reversal agents (e.g., naloxone, which reverses analgesia as well as respiratory depression) thereby permitting better pain management by enabling the use of higher doses of analgesics, facilitate weaning from prolonged ventilation, and ameliorate sleep-disordered breathing peri-operatively...
November 1, 2013: Respiratory Physiology & Neurobiology
Weimin Yang, Ming Liu, Junfang Teng, Zilong Hao, Bo Wu, Taixiang Wu, Guan J Liu
BACKGROUND: Almitrine-raubasine combination (brand name Duxil), has been considered as an alternative treatment for dementia. OBJECTIVES: To determine the clinical efficacy and safety of Duxil in the treatment of patients with dementia. SEARCH STRATEGY: We searched the Cochrane Dementia and Cognitive Improvement Group Specialised Register (now known as ALOIS) (September 2009), the China Biological Medicine Database (CBM-disc 1979 to December 2009), the Chinese National Knowledge Infrastructure (www...
2011: Cochrane Database of Systematic Reviews
Mohammad A El-Sayed
Stability-indicative determination of raubasine (RAB) in the presence of its degradate and its binary mixture with almitrine dismesylate (ALM) was investigated. The degradation product had been isolated, via acid-degradation, characterized and confirmed. Selective quantification of RAB and ALM in bulk form, pharmaceutical formulations and/or in the presence of RAB degradate was demonstrated. The analytical technique adopted for quantification was high performance liquid chromatography (HPLC). Separation was performed using a ZORBAX ODS column with a mobile phase consisting of acetonitrile+phosphate buffer pH 3...
January 15, 2011: Talanta
Mohammad A El-Sayed
A second-derivative spectrophotometric method ((2)D) and a derivative ratio spectrum zero crossing ((1)DD) method were used to determine raubasine and almitrine dismesylate in the presence of raubasine degradation product, using methanol as a solvent. Linear relationships were obtained in the range from 6-20 microg ml(-1) raubasine for the ((2)D) method and 12-24 microg ml(-1) almitrine dismesylate for the ((1)DD) method. By applying these methods it was possible to determine raubasine in its pure powdered form with an accuracy of 99...
June 2009: Drug Testing and Analysis
O N Titova, V A Ignat'ev, M D Didur, M Iu Kameneva, O A Sukhovskaia
AIM: To elucidate efficacy of a combination almitrine+thiotropium bromide (TB)+pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) of stage II-III complicated with chronic respiratory failure (CRF). MATERIAL AND METHODS: Efficacy of therapy was compared in two groups of patients: group 1 (n = 22) received TB in a dose 18 mcg/day for one year, almitrine in a dose 10 mg/kg/day for 3 months, an 8 week course of PR, group 2 (n = 17) received TB and PR...
2008: Terapevticheskiĭ Arkhiv
Wen-jie Xu, Zong-heng Li, Yong-mei Shi, Yi-huai Zou
OBJECTIVE: To find a good way to diagnose VD, value the effect of Yishen Yangnao capsule on VD and try to find some rules of changes in Chinese medicine syndromes. METHOD: Patients were randomly divided into treating group and western medicine comparison group. It's the phase III clinical research of Rishen Yangnao capsule curing VD, judging the validity and security of it, using dukexi slice as comparison drug. Some of the patients did the examination of P300. RESULT: The total validity of Yishen Yangnao capsule is 56...
April 2007: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Xiao-jun Cai, Xiu-ping Bi, Zhuo Zhao, Lei Wang
OBJECTIVE: To explore the effect of antidepressant treatment on antihypertensive therapy of senile hypertension. METHODS: 138 cases of senile hypertension complicating with depression were studied. 103 senile hypertensive patients without depression in the same period served as controls. The patients were randomly divided into 3 groups as A, B and C for study. 12.5 mg/d hydrochlorothiazide and 30 mg/d release-controlling tablets of nifedipine were orally administrated as basic antihypertensive medication each group...
August 2006: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
D M Payen, J Muret
Hypoxia-induced by acute lung injury results from abnormal ventilation/perfusion ratio distribution towards shunt or low ventilation/perfusion zones. Pharmacological modification of pulmonary blood flow distribution improving ventilation/perfusion ratio should correct hypoxia. The development of inhaled nitric oxide therapy had confirmed this concept, but with a relatively high proportion of 'non responders'. Then development of other drugs used alone or in association with nitric oxide may reinforce the benefit of nitric oxide...
February 1999: Current Opinion in Anaesthesiology
Jayan Nagendran, Ken Stewart, Mike Hoskinson, Stephen L Archer
PURPOSE OF THE REVIEW: Hypoxic pulmonary vasoconstriction is the pulmonary circulation's homeostatic mechanism for matching regional perfusion to ventilation and optimizing systemic PaO2. The role of hypoxic pulmonary vasoconstriction in anesthesiology is reviewed. RECENT FINDINGS: In hypoxic pulmonary vasoconstriction, airway hypoxia causes resistance pulmonary arteries to constrict, diverting blood to better-oxygenated alveoli. Hypoxic pulmonary vasoconstriction optimizes O2 uptake in atelectasis, pneumonia, asthma, and adult respiratory distress syndrome...
February 2006: Current Opinion in Anaesthesiology
T Silva-Costa-Gomes, L Gallart, J Vallès, L Trillo, J Minguella, M M Puig
BACKGROUND: Almitrine combined with inhaled nitric oxide (NO) can prevent hypoxia during one-lung ventilation (OLV). The optimal dose of almitrine that would provide therapeutic advantage with few side-effects during open-chest OLV has not been established. METHODS: Forty-two patients undergoing thoracotomy were randomly allocated to three groups: placebo, almitrine 4 microg kg(-1) min(-1) and inhaled NO 10 p.p.m. (ALM4+NO), and almitrine 16 microg kg(-1) min(-1) and inhaled NO 10 p...
September 2005: British Journal of Anaesthesia
Shunwei Li, Jie Long, Zhizhong Ma, Zhongbao Xu, Jing Li, Zhuo Zhang
BACKGROUND AND OBJECTIVES: Stroke is a major cause of disability. Certain experimental studies have suggested that a combination of almitrine + raubasine (Duxil) increases the supply of oxygen to cerebral tissues and may be beneficial in post-stroke rehabilitation. This multicentre clinical study was carried out in order to assess the efficacy of this combination on poststroke rehabilitation. METHODS: The trial was a randomised, double-blind, placebo-controlled study...
March 2004: Current Medical Research and Opinion
Nicolas Dalibon, Marc Moutafis, Ngai Liu, Jean-Dominique Law-Koune, Stéphanie Monsel, Marc Fischler
UNLABELLED: We performed this prospective randomized double-blinded study to assess the ability of almitrine to treat hypoxemia during one-lung ventilation (OLV). Twenty-eight patients were anesthetized with propofol, sufentanil, and atracurium; lung separation was achieved with a double-lumen tube. A transesophageal Doppler probe was inserted to evaluate cardiac index. If SpO(2) was equal to or decreased to <95% during OLV (inspired fraction of oxygen of 0.6), patients were included in the study and received a placebo or almitrine (12 microg x kg(-1) x min(-1) for 10 min followed by 4 microg x kg(-1) x min(-1)) infusion until SpO(2) reached 90% or decreased to <90% (exclusion from the study)...
March 2004: Anesthesia and Analgesia
D Köhler
No abstract text is available yet for this article.
September 2003: Respiration; International Review of Thoracic Diseases
P V van Heerden, P D Cameron, A Karanovic, M A Goodman
We present a case of orthodeoxia (postural hypoxaemia) which resulted from a combination of lung collapse/consolidation and blunted hypoxic pulmonary vasoconstriction due to partial interruption of the sympathetic nerve supply to the lung by bilateral thoracic sympathectomy.
October 2003: Anaesthesia and Intensive Care
D Górecka, P Sliwiński, G Pałasiewicz, R Pachocki, J Zieliński
BACKGROUND: Advanced chronic obstructive pulmonary disease (COPD) generates high costs, especially when patients require domiciliary long-term oxygen therapy (LTOT). Almitrine bismesylate has been shown to improve gas exchange in the lungs. Our hypothesis was that long-term treatment with almitrine might postpone the prescription of LTOT. OBJECTIVE: To evaluate the effects of almitrine sequential treatment on arterial blood gases in COPD patients with moderate hypoxaemia...
May 2003: Respiration; International Review of Thoracic Diseases
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