Shoemaker W C, Appel P L
Surgery. 1986 Mar;99(3):275-83.
Prostaglandin E1 (PGE1, Prostin VR) in doses of 30 ng/kg . min was studied in two series of severely ill surgical patients with adult respiratory distress syndrome (ARDS). First the drug was administered in an initial trial in six patients; then a prospective, randomized, blinded trial was conducted in 10 studies on nine patients. PGE1 markedly decreased pulmonary artery pressure, pulmonary and systemic vascular resistance indexed, and venous pressures, while increasing cardiac output, arterial PO2 (PaO2), oxygen delivery, and oxygen consumption when compared with the baseline preinfusion control values and with the response of the placebo-treated control series. The PGE1 responses were greater in patients whose ARDS was primarily attributed to the postoperative state with or without sepsis and least in patients with cirrhosis. The data are consistent with the concept that the drug reduces vasoconstriction primarily in the pulmonary circulation but also in the systemic circulation; improved PaO2 usually follows the hemodynamic effect. We conclude that PGE1 may be a useful adjunctive therapy for ARDS.
以30纳克/千克·分钟的剂量对两组患有成人呼吸窘迫综合征（ARDS）的重症外科患者进行了前列腺素E1（PGE1，前列地尔）研究。首先，在6名患者中进行了初步试验给药；然后，对9名患者进行了10项前瞻性、随机、双盲试验。与输注前的基线对照值以及安慰剂治疗的对照系列反应相比，PGE1显著降低了肺动脉压、肺血管和体循环血管阻力指数以及静脉压，同时增加了心输出量、动脉血氧分压（PaO2）、氧输送和氧消耗。ARDS主要归因于术后状态（无论有无脓毒症）的患者对PGE1的反应更大，而肝硬化患者的反应最小。这些数据与该药物主要减少肺循环但也减少体循环中的血管收缩这一概念一致；PaO2的改善通常跟随血流动力学效应。我们得出结论，PGE1可能是ARDS的一种有用辅助治疗方法。
