Vasodilators in mechanical ventilation

J. L. Zimmerman, N. A. Hanania

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Vasodilators that affect the pulmonary vasculature are appealing adjuncts in many cardiopulmonary conditions that require mechanical ventilation such as ARDS, COPD, PPHN, and cardiothoracic surgery. The adverse systemic effects of parenteral PGE1 and parenteral prostacyclin limit their usefulness in critically ill patients. Liposomal PGE1 has few systemic effects, but thus far has not resulted in a significant clinical benefit in patients with ARDS. Inhaled NO and aerosolized prostacyclin offer the advantage of selective pulmonary vasodilation with minimal systemic effects. Both agents decrease PAP and in many clinical situations improve oxygenation; however, the physiologic effects of inhaled NO and aerosolized prostacyclin have not convincingly led to improved clinical outcomes. Currently, use of vasodilators in mechanically ventilated patients remains investigational.

Original languageEnglish (US)
Pages (from-to)611-627
Number of pages17
JournalCritical Care Clinics
Volume14
Issue number4
DOIs
StatePublished - 1998

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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