EFFECTS OF PROSTAGLANDIN-E1 ON OXYGEN DELIVERY AND CONSUMPTION IN PATIENTS WITH THE ADULT RESPIRATORY-DISTRESS SYNDROME - RESULTS FROM THE PROSTAGLANDIN-E1 MULTICENTER TRIAL

We wanted to determine the long-term effects of a continuous infusion of PGE1 on ḊO2 and V̇O2 in patients with ARDS. Data were obtained from a randomized double-blind multicenter trial, which evaluated the effects of PGE1 on survival in patients with ARDS. Patients were stratified according to treatment and outcome: placebo-died (n = 8); PGE1-died (n = 12); placebo-survived (n = 9); and PGE1-survived (n = 8). In the placebo-died group, elevations occurred in V̇O2, which were associated with increases in O2ext and a constant ḊO2. In contrast, in the PGE1-died group, elevations in V̇O2 were associated with increases in ḊO2 and an unchanged O2ext. In the placebo-survived group, V̇O2 and ḊO2 decreased, whereas in the PGE1-survived group, V̇O2 and ḊO2 increased; however, O2ext decreased in both of these groups. Since impaired O2ext occurs in ARDS, PGE1-induced elevations in ḊO2, rather than compensatory increases in O2ext, may achieve better tissue oxygenation. We conclude that although the recently completed multicenter trial failed to show an enhancing effect of PGE1 on survival in patients with advanced ARDS, PGE1 may have important effects on oxygen transport and, therefore, may still have a role in the treatment of early manifestations of ARDS, either alone or in combination with other agents.