Overview

Inhaled Prostacyclin for Adult Respiratory Distress Syndrome (ARDS) and Pulmonary Hypertension

Status:
Completed

Trial end date:
2009-07-01

Target enrollment:
0

Participant gender:
All

Summary

Summary of the proposed research: The intravenous application of prostacyclin (PGE1) or its stable analogue, iloprost, has been used to cause a decrease not only of the pulmonary but also of the systemic vascular tone. Aerosolized prostacyclin, on the other hand, can result in a selective pulmonary vasodilatation without affecting the systemic blood pressure as shown in preliminary studies/case reports. No large trials exist for this type of use of the drug so far. Furthermore, aerosolized PGI2 can improve gas exchange and pulmonary shunt in clinical settings of impaired ventilation/perfusion ratio as it occurs in adult respiratory distress syndrome (ARDS) due to the redistribution of pulmonary blood flow from non-ventilated to ventilated, aerosol accessible lung regions. Therefore, the investigators propose to carry out a prospective, double blinded, randomized trial to show that the nebulized iloprost decreases pulmonary hypertension selectively and improves oxygenation in ARDS.

Phase:

N/A

Accepts Healthy Volunteers?

Details

Lead Sponsor:

Aga Khan University

Collaborator:

Medical Research Council, Pakistan

Treatments:

Alprostadil
Epoprostenol
Tezosentan

Criteria

Inclusion Criteria:

After obtaining informed consent the following patients will be included:

- All patients admitted to the ICU with pulmonary hypertension (mean PA > 35 mmHg).

- All patients in ICU with post operative pulmonary HTN (mean PA > 35 mm Hg).

- All patients with ARDS (PaO2/FiO2 < 200 - arterial hypoxemia, bilateral infiltrates on
Chest X-ray infiltrates on CXR and a wedge < 20 mm Hg on swan ganz parameters) or
signs of heart failure.

Exclusion Criteria:

Patients to be excluded will be those with:

- Pulmonary embolus.

- Cor pulmonale.

- Ejection fraction of < 30%, wedge > 20 mm Hg.

- Non-intubated patients.

- Pediatric patients (< 16 yrs of age).