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Hemodynamic monitoring and vasodilator therapy in acute left ventricular failure. Preliminary report on a new vasodilator, tolmesoxide.

Data, obtained by invasive hemodynamic monitoring, are now routinely available in our Intensive Care Unit, and are processed by means of a small calculator to a cardiovascular profile, including O2 transport/consumption, vascular resistance and ventricular work values. Patients with clinically persistent shock states, after 12-24 hours optimal classical cardiovascular therapy, are invasively studied. Vasodiltor therapy frequently improves not only hemodynmic parameters, but also oxygen delivery to the tissues. Tolmesoxide, a new peripheal vasodilator, has been used in eleven patients. Preliminary results are discussed.

Acute Disease↗

Endothelium-dependent vasodilation by LP-805, a novel vasodilating agent, on rat thoracic aorta.

1. In rat aortae with [E(+)-tissue] and without [E(-)-tissue] intact endothelium, LP-805 relaxed the preparations precontracted with 35.9 mM K+ and its action in E(+)-tissues was more potent than that in E(-)-tissues. Moreover, the inhibitory action of glibenclamide in E(-)-tissues was more potent than that in E(+)-tissues. 2. The relaxing action of LP-805 on E(+)-tissues treated with NG-nitro-L-arginine methyl ester (10 microM), a potent inhibitor of nitric oxide synthesis, was the same as that in E(-)-tissues. 3. Methylene blue (10 microM) also inhibited the LP-805 induced relaxation in E(+)-tissues. 4. Indomethacin (10 microM) had no effect on LP-805-induced relaxation in E(+)-tissues. 5. These results suggest that the vasorelaxant action of LP-805 involves the mechanism which causes the release of nitric oxide (NO) from vascular endothelium.

Animals↗

The medullary cerebrovascular vasodilator area mediates cerebrovascular vasodilation and electroencephalogram synchronization elicited from cerebellar fastigial nucleus in Sprague-Dawley rats.

We investigated whether the medullary cerebrovasodilator area (MCVA), a region of ventral medulla mediating elevations of regional cerebral blood flow (rCBF) and electroencephalogram (EEG) synchronization elicited in cerebral cortex from stimulation of reticulospinal neurons of rostral ventrolateral medulla (RVLM), also mediates comparable responses from the cerebellar fastigial nucleus (FN). In spinalized rats, electrical stimulation of MCVA, RVLM or FN elevated rCBF and synchronized the EEG. The FN-evoked responses were significantly attenuated or blocked by bilateral lesions of MCVA. The MCVA is a novel region of medullary reticular formation mediating actions of medullary and cerebellar centers on rCBF and EEG to link visceral centers of brainstem and cerebral cortex.

Animals↗

[Comparative study of acoustic trauma caused by blasts, treated by vasodilators or by a combination of vasodilators and hyperbaric oxygenation].

The authors had comparated two series of patients with noise induced hearing loss treated by vasodilatators or vasodilatators and hyperbaric oxygen. This therapy seems to give better results than the vasodilatators only, but the patients had to be treated before ten days after the noise exposition. In the two series of acoustic trauma we see rarely a complete recovery from the hearing loss.

Adult↗