CHEST Guidelines-Efficacy-of-Almitrine-in-the-Treatment-of-Hypoxemi

Efficacy-of-Almitrine-in-the-Treatment-of-Hypoxemi

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A study published in the journal "Chest" explored the efficacy of almitrine, a drug noted for enhancing hypoxic pulmonary vasoconstriction (HPV), in treating hypoxemia in patients with COVID-19-induced Acute Respiratory Distress Syndrome (ARDS). Conducted at Hôpital Lariboisière in Paris, this monocenter retrospective study reviewed 86 ICU patients admitted between March and April 2020, out of which 19 met the inclusion criteria for almitrine infusion. The study's primary aim was to evaluate the changes in the PaO2/FIO2 ratio within six hours of almitrine administration.<br /><br />Almitrine was hypothesized to enhance gas exchange by decreasing intrapulmonary shunt. Results showed that the median PaO2/FIO2 ratio increased significantly from 79 to 117 post-treatment, indicating an improvement in oxygenation. However, there was variation in patient response, and some required additional interventions or succumbed despite improved oxygenation. In terms of safety, almitrine was associated with a slight increase in arterial lactate levels but did not significantly affect right atrial pressure or liver enzymes.<br /><br />While the study showed that almitrine could be a beneficial intervention strategy for severe hypoxemia in COVID-19 ARDS, the authors noted the necessity of clinical trials to better determine its impact on patient-centered outcomes. They also suggested that early intervention with almitrine might help in managing ventilator resources during the pandemic. Despite promising findings, the heterogenous patient responses highlighted the need for further research to understand almitrine's role fully and to optimize its timing and dosage in clinical practice.

Keywords

almitrine

hypoxic pulmonary vasoconstriction

hypoxemia

COVID-19

Acute Respiratory Distress Syndrome

PaO2/FIO2 ratio

intrapulmonary shunt

oxygenation improvement

clinical trials

ventilator resources