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Hemodynamic effects of iloprost, a prostacyclin analog
Author(s) -
Kaukinen Seppo,
Ylitalo Pauli,
Pessi Teuvo,
Vapaatalo Heikki
Publication year - 1984
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1984.205
Subject(s) - iloprost , cardiac output , medicine , hemodynamics , cardiac index , vascular resistance , afterload , heart rate , anesthesia , stroke volume , prostacyclin , mean arterial pressure , pulmonary wedge pressure , blood pressure , cardiology
Iloprost is a chemically stable derivative of carbaprostacyclin. We studied its hemodynamic effects in 10 patients in an intensive care unit. Iloprost was infused intravenously for 3 days for the treatment of advanced obliterative arterial disease of the lower extremities. Clinically significant hemodynamic responses were obtained with an infusion rate of 0.5 ng/kg/min. All subjects tolerated the dose of 4 ng/kg/min, which increased heart rate an average of 11% and cardiac index an average of 26%. This infusion rate decreased mean arterial pressure by 15%, total peripheral resistance by 31%, and pulmonary vascular resistance by 34%. Mean pulmonary arterial pressure, pulmonary capillary wedge pressure, left and right ventricular stroke work indices, and rate pressure product did not change. At higher doses of up to 8 ng/kg/min, responses were augmented only slightly, but side effects such as headache, nausea, and abdominal colics became more prominent. The data show iloprost to be a potent vasodilator that reduces both pre‐ and afterload and presumably induces a compensatory increase in cardiac output and heart rate, but does not increase the work load or oxygen demand of the heart. Clinical Pharmacology and Therapeutics (1984) 36, 464–469; doi: 10.1038/clpt.1984.205