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首页> 外文期刊>Current opinion in anaesthesiology >Treatment of pulmonary hypertension with selective pulmonary vasodilators.
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Treatment of pulmonary hypertension with selective pulmonary vasodilators.

机译:用选择性肺血管扩张药治疗肺动脉高压。

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PURPOSE OF REVIEW: Pulmonary vasodilators are important in the management of pulmonary hypertension. Although systemic vasodilators may be effective in lowering pulmonary artery pressure, systemic vasodilation is the main limitation to dose titration. This review summarizes the latest research and developments in pulmonary vasodilators in the management of acute and chronic pulmonary hypertension. RECENT FINDINGS: Nitric oxide, the prototype of selective pulmonary vasodilators, remains an effective option in the management of pulmonary hypertension; however, cost and complexity of administration have led to consideration of other pulmonary vasodilators. Animal research suggests that nitric oxide may have an important role in the prevention of pulmonary hypertension after cardiopulmonary bypass. Experience with phosphodiesterase inhibitors, as monotherapy or as part of combination therapy, suggests that these agents improve cardiopulmonary hemodynamics and can be considered as alternatives and/or adjuncts to nitric oxide. Prostacyclins are a versatile class of pulmonary vasodilator as they have been shown to improve pulmonary hemodynamics administered intravenously or via inhalation. Endothelin receptor antagonists have been shown to be effective for long-term management of pulmonary hypertension. Several gene therapy strategies are currently undergoing evaluation. SUMMARY: Selective pulmonary vasodilation can be achieved through delivery of vasodilators directly to the lungs or targeting pulmonary specific processes. Several therapeutic options are available that demonstrate selectivity for the pulmonary vasculature. These agents can facilitate optimization of cardiopulmonary hemodynamics.
机译:审查目的:肺血管扩张剂在管理肺动脉高压中很重要。尽管全身性血管舒张剂可能有效降低肺动脉压力,但全身性血管舒张是剂量滴定的主要限制。这篇综述总结了在急性和慢性肺动脉高压的治疗中肺血管扩张剂的最新研究和进展。最新发现:一氧化氮是选择性肺血管扩张剂的原型,在管理肺动脉高压方面仍然是有效的选择。但是,给药的费用和复杂性导致需要考虑其他肺血管扩张药。动物研究表明,一氧化氮可能在预防体外循环后的肺动脉高压中起重要作用。磷酸二酯酶抑制剂的经验(作为单一疗法或作为联合疗法的一部分)表明,这些药物可改善心肺血流动力学,可被视为一氧化氮的替代品和/或辅助剂。前列环素是一类通用的肺血管扩张剂,因为它们已被证明可以改善静脉内或通过吸入给药的肺血流动力学。内皮素受体拮抗剂已被证明对肺动脉高压的长期治疗有效。目前正在评估几种基因治疗策略。简介:选择性肺血管扩张可通过将血管扩张剂直接递送至肺部或靶向肺特异性过程来实现。有几种治疗选择可证明对肺血管的选择性。这些药物可以促进优化心肺血流动力学。

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