Efeito de diferentes frações inspiradas de oxigênio sobre a ação anti-hipertensiva pulmonar do sildenafil

• Autor(a) principal: Becerra Velásquez, Diana Rocio [UNESP]
• Data de Publicação: 2015
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://hdl.handle.net/11449/131966; http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/05-10-2015/000847963.pdf
• topic: Embolia pulmonar; Hipertensão pulmonar; Ovino; Agentes hipotensores; Anestesia veterinaria; Pulmonary hipertension

Sildenafil is a pulmonary anti-hypertensive agent whose action could be modified by different fractions of inspired oxygen (FiO2). The effects of pure oxygen (FiO2 > 90%) or room air (21% FiO2) on the cardiopulmonary actions of sildenafil were compared in sheep with acute pulmonary embolism (APE). Thirty two anesthetized, mechanically ventilated sheep (34.9 ± 5.4 kg), were randomly distributed into four groups (n = 8 per group): FiO2> 90% without intervention (Sham90); APE induced by microspheres with FiO2 > 90%, followed 30 min later by placebo (Emb90); or APE followed 30 min later by intravenous sildenafil (0.7 mg/kg over 30 minutes) with FiO2 > 90% (Emb+Sild90) or FiO2 = 21% (Emb+Sild21). Variables were recorded until 30 min after the end of treatment administration. Microsphere injection increased (P < 0.05) mean pulmonary artery pressure (MPAP) in all embolized groups (111-140% higher than baseline). Compared with values recorded 30 min after induction of APE (E30), sildenafil induced greater decreases in MPAP in the Emb+Sil90 group than in the Emb+Sil21 group (23% and 14% lower than E30, respectively). Hypotension (mean arterial pressure < 60 mm Hg) was precipitated by sildenafil due to systemic vasodilation in the Emb+Sil21 group. Embolization significantly lowered the PaO2/FiO2 ratio and significantly increased venous admixture. However, sildenafil did not alter the oxygenation impairment induced by APE. Sildenafil induces a more consistent pulmonary anti-hypertensive effect and causes less interference with the systemic circulation with the concomitant use of pure oxygen than with room air in the setting of APE