The haemodynamic and respiratory effects of intravenous nimodipine used in the treatment of eclampsia

Objective To establish the antihypertensive properties of intravenous nimodipine used to treat eclamptic patients. To assess the effects of intravenous nimodipine on oxygen delivery and consumption. Design A prospective observational study. Setting The Maternity Centre Obstetric Intensive Care Unit, Groote Schuur Hospital. Participants Four unselected patients presenting with proteinuric hypertension and seizures. Methods Haemodynamic observations were obtained by a radial artery catheter and right heart catheterisation with a pulmonary artery flow directed thermodilution catheter. Observations were obtained prior to and after the administration of nimodipine. Results A significant reduction in mean arterial pressure occurred in all patients after administration of nimodipine. This was due to a significant reduction in systemic vascular resistance. Neither oxygen delivery to the tissues nor peripheral oxygen consumption changed significantly during nimodipine infusion. No adverse effects related to the use of nimodipine were documented. Conclusions Nimodipine is an effective vasodilator. There may be a role for nimodipine as a single agent for the management of eclampsia.