Dolor torácico agudo

The effect of aminophylline on cerebral blood flow in patients with chronic obstructive pulmonary disease.
D L Bowton, P T Alford, B D McLees, D S Prough and D A Stump Chest 1987;91;874-877 DOI 10.1378/chest.91.6.874 The online version of this article, along with updated information and services can be found online on the World Wide Web at: http://chestjournal.chestpubs.org/content/91/6/874Chest is the official journal of the American College of Chest Physicians. It has been published monthly since 1935. Copyright1987by the American College of Chest Physicians, 3300 Dundee Road, Northbrook, IL 60062. All rights reserved. No part of this article or PDF may be reproduced or distributed without the prior written permission of the copyright holder.(http://chestjournal.chestpubs.org/site/misc/reprints.xhtml) ISSN:0012-3692

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The Effect of Aminophylline on Cerebral Blood Flow in Patients with Chronic Obstructive Pulmonary Disease*
David Byron David L. Bowton, M.D., M.D., Ph.D.1 F.C.C.P;t Ph.D.; Peter T Alford, M.D., M.D.;t FC.C.P; and D. McLees, A. Stump,DonaldS. Prough,

Aminophylline cerebral blood

has flow

been shown (CBF) in

to produce a reduction animal models and

in

patients

with

symptoms or signs. The effect CBF (rCBF) in patients with chronic obstructive pulmonary disease (COPD) has not previously been reported to our knowledge. We studied the effect of loading and maintenance infusions of aminophylline on CBF in fivesubjects with moderate to severe COPD. rCBF was determined in eight homologous regions
aminophylline on regional of each cerebral hemisphere at three intervals: (1) baseline;

neurologic

the IV loading dose of aminophylline (6.0 mg/kg and (3) early and late in the maintenance ofinfusion (0.5 mg/kg/hr) period. Aminophylline loading caused a 26 percent reduction = (p 0.005) in mean rCBF from40.6 ± 5.2 (SD) ml/l00 g/min to 30.1 ± 6.0 ml/100 g/min. A 23 percent reduction (31.5 6.9 ml/100 g/min) ± persisted throughout the maintenance phase. Thus, aminophylline, as customarily used in subjects with COPD, is associated with a significant reduction in rCBF.
body weight);

(2) following

In
The

the 1950s clinically patients who beneficial cerebral (CBF), muscle However, Schmidt’sRasmussen’s For patients and in ease or phylline increased of CBF monary previously commonly cerebral ate to severe in

and 1960s to produce had sustained effects

aminophylline was employed neurologic improvement cerebrovascular accidents.’ were assumed to be related increased was

MATERIALS

AND by consent female Each with history to irflow a tests and lung was using levels samplesanalyzer). to xanthine to consume study. each with investigators (Nal) positions No continue the had our subjects

METHODS institutional was obtained had a clinical diagnosis of cigarette a mean history moderate use by blood gas befure was a water-sealed Thoracic measured analyzed the no coffee, were allowed blood NOVO by The detectors to correspond electrode administration supine determinationconcentrations. were the from dose Another the baseline of 6 rCBF CBF solution, 16 probes rCBF mg/kg body measurestable study was were on face mask system. of xenon a table and was used of the endand fitted S.). NOVO use for for were were studies the clinically study, spirometer Society by liquid PaO2 guidechroPaCO,, n-agonist four days caffeinated in other minutes flow Obrist (eight laboracereet al’system per with to and clinical from each age physical and to pulmonary were during stable. The a severe significant practices subject. of 54 years

in toThe

This review (range, examination COPD, irreversible function three

protocol board, male 42 to and

was and 65

approved infurmed two years).

vasodilation and since aminophylline relaxant/peripheral subsequent N20 ‘Xe editorial...