Department of Anesthesiology and Resuscitation, Hamamatsu University School of Medicine, 1-20-1 Handayama, Nagoya, 431-3192 Japan ; Department of Pediatrics and Developmental Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan.
Department of Anesthesiology and Resuscitation, Hamamatsu University School of Medicine, 1-20-1 Handayama, Nagoya, 431-3192 Japan.
J Intensive Care. 2014 Jan 23;2(1):6. doi: 10.1186/2052-0492-2-6. eCollection 2014.
Landiolol is an ultra-short-acting β1-selective antagonist developed in Japan that was recently approved for the treatment of tachycardia in intensive care units (ICUs). This study investigated the protective effects of landiolol against the cardiovascular responses during bronchoscopic endotracheal suctioning. This study enrolled 15 patients requiring orotracheal intubation in an ICU. All of the patients required endotracheal suctioning using fiber bronchoscopy while sedated at a Ramsay Scale of 2-3. All subsequent suctioning procedures were assigned randomly to three groups using a cross-over design: saline as a placebo (group C) or 20 or 40 μg kg(-1) min(-1) landiolol, respectively (groups L20 and L40). The infusion was started 3 min before bronchoscopy and continued for 6 min. The central venous pressure (CVP) heart rate (HR) and arterial blood pressure (BP) were recorded. Fourteen patients completed the investigation, and 30 procedures (n = 10/group) were analyzed. The suctioning significantly increased the CVP, HR, and BP in groups C and L20, although the changes in BP were of shorter duration in group L20. No significant increase in the hemodynamic parameters was observed in group L40. The administration of landiolol 40 μg kg(-1) min(-1) prevented a harmful hyperdynamic circulatory response to bronchoscopic endotracheal suctioning, without obvious decreases in HR or BP after the intervention.
兰地洛尔是一种在日本开发的超短效β1 选择性拮抗剂，最近被批准用于治疗重症监护病房（ICU）中的心动过速。本研究旨在探讨兰地洛尔对支气管镜经鼻气管内吸引过程中心血管反应的保护作用。
该研究纳入了 15 名在 ICU 需要经口气管插管的患者。所有患者均在 Ramsay 镇静评分 2-3 时接受纤维支气管镜下经鼻气管内吸引，所有后续的吸引操作均采用交叉设计随机分为三组：生理盐水作为安慰剂（C 组）或分别给予 20 或 40μg·kg-1·min-1 兰地洛尔（L20 组和 L40 组）。在支气管镜检查前 3 分钟开始输注，并持续 6 分钟。记录中心静脉压（CVP）、心率（HR）和动脉血压（BP）。14 名患者完成了研究，共分析了 30 次操作（每组 n=10）。与 C 组和 L20 组相比，吸引操作显著增加了 CVP、HR 和 BP，尽管 L20 组的 BP 变化持续时间较短。L40 组的血流动力学参数无显著增加。给予 40μg·kg-1·min-1 兰地洛尔可预防支气管镜经鼻气管内吸引引起的有害高动力循环反应，干预后 HR 或 BP 无明显下降。
