Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Olschewski, H; Ghofrani, HA; Schmehl, T; Winkler, J; Wilkens, H; Höper, MM; Behr, J; Kleber, FX; Seeger, W.
Inhaled iloprost to treat severe pulmonary hypertension. An uncontrolled trial. German PPH Study Group.
Ann Intern Med. 2000; 132(6):435-443
Doi: 10.7326/0003-4819-132-6-200003210-00003
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- Führende Autor*innen der Med Uni Graz
- Olschewski Horst
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- Abstract:
- BACKGROUND: Inhaled aerosolized iloprost, a stable prostacyclin analogue, has been considered a selective pulmonary vasodilator in the management of pulmonary hypertension. OBJECTIVE: To assess the efficacy of inhaled iloprost in the treatment of life-threatening pulmonary hypertension. DESIGN: Open, uncontrolled, multicenter study. SETTING: Intensive care units and pulmonary hypertension clinics at six university hospitals in Germany. PATIENTS: 19 patients who had progressive right-heart failure despite receiving maximum conventional therapy (12 with primary pulmonary hypertension, 3 with pulmonary hypertension related to collagen vascular disease without lung fibrosis, and 4 with secondary pulmonary hypertension). INTERVENTION: Inhaled iloprost, 6 to 12 times daily (50 to 200 microg/d). MEASUREMENTS: Right-heart catheterization and distance walked in 6 minutes at baseline and after 3 months of therapy. RESULTS: During the first 3 months of therapy, New York Heart Association functional class improved in 8 patients and was unchanged in 7 patients. Four patients died, 3 of right-heart failure and 1 of sepsis. The acute hemodynamic response to inhaled iloprost was predominant pulmonary vasodilatation with little systemic effect at baseline and at 3 months (data available for 12 patients). Hemodynamic variables were improved at 3 months, and the distance walked in 6 minutes improved by 148 m (95% CI, 4.5 to 282 m; P = 0.048). Of the 15 patients who continued to use inhaled iloprost, 8 stopped: Four had lung transplantation, 1 switched to intravenous prostacyclin therapy, and 3 died. Seven patients are still receiving inhaled iloprost (mean +/-SD) duration of therapy, 536 +/- 309 days; mean dosage, 164 +/- 38 microg/d). CONCLUSIONS: Inhaled iloprost may offer a new therapeutic option for improvement of hemodynamics and physical function in patients with life-threatening pulmonary hypertension and progressive right-heart failure that is refractory to conventional therapy.
- Find related publications in this database (using NLM MeSH Indexing)
- Administration, Inhalation -
- Adult -
- Aged -
- Exercise Tolerance - drug effects
- Female - drug effects
- Follow-Up Studies - drug effects
- Heart Failure, Congestive - drug therapy
- Hemodynamic Processes - drug effects
- Humans - drug effects
- Hypertension, Pulmonary - drug therapy
- Iloprost - administration and dosage
- Male - administration and dosage
- Middle Aged - administration and dosage
- Pulmonary Gas Exchange - drug effects
- Statistics, Nonparametric - drug effects
- Treatment Outcome - drug effects
- Vasodilator Agents - administration and dosage
- Find related publications in this database (Keywords)
- iloprost
- hypertension
- hemodynamics
- pulmonary heart disease
- administration
- inhalation