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The optimization of iloprost inhalation under moderate flow of oxygen therapy in severe pulmonary arterial hypertension
Inhaled iloprost efficiently improves pulmonary hemodynamics, exercise capacity, and quality of life in patients with pulmonary arterial hypertension (PAH). However, the process of inhalation is laborious for patients suffering from resting dyspnea. We describe a 75-year-old man with idiopathic PAH...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024293/ https://www.ncbi.nlm.nih.gov/pubmed/29781778 http://dx.doi.org/10.1177/2045894018781537 |
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author | Nakayama, Kazuhiko Emoto, Noriaki Tamada, Naoki Okano, Mitsumasa Shinkura, Yuto Yanaka, Kenichi Onishi, Hiroyuki Hiraishi, Mana Yamada, Shinichiro Tanaka, Hidekazu Shinke, Toshiro Hirata, Ken-ichi |
author_facet | Nakayama, Kazuhiko Emoto, Noriaki Tamada, Naoki Okano, Mitsumasa Shinkura, Yuto Yanaka, Kenichi Onishi, Hiroyuki Hiraishi, Mana Yamada, Shinichiro Tanaka, Hidekazu Shinke, Toshiro Hirata, Ken-ichi |
author_sort | Nakayama, Kazuhiko |
collection | PubMed |
description | Inhaled iloprost efficiently improves pulmonary hemodynamics, exercise capacity, and quality of life in patients with pulmonary arterial hypertension (PAH). However, the process of inhalation is laborious for patients suffering from resting dyspnea. We describe a 75-year-old man with idiopathic PAH and a low gas transfer. Investigations excluded significant parenchymal lung disease and airflow obstruction (presuming FEV1/FVC ration > 70%). The patient struggled to complete iloprost inhalation due to severe dyspnea and hypoxemia. As such, we optimized the methods of oxygen supply from the nasal cannula to the trans-inhalator during the inhalation. We successfully shortened the inhalation duration that effectively reduced the laborious efforts required of patients. We also recorded pulmonary hemodynamics during inhalation of nebulized iloprost. This revealed significant hemodynamic improvement immediately following inhalation but hemodynamics returned to baseline within 2 hours. We hope that this optimization will enable patients with severe PAH to undergo iloprost inhalation. |
format | Online Article Text |
id | pubmed-6024293 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-60242932018-07-05 The optimization of iloprost inhalation under moderate flow of oxygen therapy in severe pulmonary arterial hypertension Nakayama, Kazuhiko Emoto, Noriaki Tamada, Naoki Okano, Mitsumasa Shinkura, Yuto Yanaka, Kenichi Onishi, Hiroyuki Hiraishi, Mana Yamada, Shinichiro Tanaka, Hidekazu Shinke, Toshiro Hirata, Ken-ichi Pulm Circ Case Report Inhaled iloprost efficiently improves pulmonary hemodynamics, exercise capacity, and quality of life in patients with pulmonary arterial hypertension (PAH). However, the process of inhalation is laborious for patients suffering from resting dyspnea. We describe a 75-year-old man with idiopathic PAH and a low gas transfer. Investigations excluded significant parenchymal lung disease and airflow obstruction (presuming FEV1/FVC ration > 70%). The patient struggled to complete iloprost inhalation due to severe dyspnea and hypoxemia. As such, we optimized the methods of oxygen supply from the nasal cannula to the trans-inhalator during the inhalation. We successfully shortened the inhalation duration that effectively reduced the laborious efforts required of patients. We also recorded pulmonary hemodynamics during inhalation of nebulized iloprost. This revealed significant hemodynamic improvement immediately following inhalation but hemodynamics returned to baseline within 2 hours. We hope that this optimization will enable patients with severe PAH to undergo iloprost inhalation. SAGE Publications 2018-06-13 /pmc/articles/PMC6024293/ /pubmed/29781778 http://dx.doi.org/10.1177/2045894018781537 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Case Report Nakayama, Kazuhiko Emoto, Noriaki Tamada, Naoki Okano, Mitsumasa Shinkura, Yuto Yanaka, Kenichi Onishi, Hiroyuki Hiraishi, Mana Yamada, Shinichiro Tanaka, Hidekazu Shinke, Toshiro Hirata, Ken-ichi The optimization of iloprost inhalation under moderate flow of oxygen therapy in severe pulmonary arterial hypertension |
title | The optimization of iloprost inhalation under moderate flow of oxygen therapy in severe pulmonary arterial hypertension |
title_full | The optimization of iloprost inhalation under moderate flow of oxygen therapy in severe pulmonary arterial hypertension |
title_fullStr | The optimization of iloprost inhalation under moderate flow of oxygen therapy in severe pulmonary arterial hypertension |
title_full_unstemmed | The optimization of iloprost inhalation under moderate flow of oxygen therapy in severe pulmonary arterial hypertension |
title_short | The optimization of iloprost inhalation under moderate flow of oxygen therapy in severe pulmonary arterial hypertension |
title_sort | optimization of iloprost inhalation under moderate flow of oxygen therapy in severe pulmonary arterial hypertension |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024293/ https://www.ncbi.nlm.nih.gov/pubmed/29781778 http://dx.doi.org/10.1177/2045894018781537 |
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