thiopental and Pulmonary-Edema

Pentoxifylline exhibits rheological properties that improve microvascular flow and it is widely used in vascular perfusion disorders. It also exhibits marked anti-inflammatory properties by inhibiting tumour necrosis factor alpha production. Thiopental is one of the most widely used drugs for rapid induction of anaesthesia. During experimental studies on the treatment of acute pancreatitis, we observed that when pentoxifylline was administered after anaesthesia with thiopental, most of the rats exhibited dyspnea, signs of pulmonary oedema and died. The aim of the work described here was to investigate the cause of the unexpected toxic effect of the combined treatment with thiopental and pentoxifylline.. Pulmonary vascular permeability and arterial blood gases were measured, and a histological analysis was performed. The possible role of haemodynamic changes in the formation of pulmonary oedema was also assessed.. Co-administration of pentoxifylline and thiopental increased pulmonary vascular permeability and markedly decreased arterial pO2, with one third of rats suffering from hypoxemia. This combined treatment caused death by acute pulmonary oedema in 27% of normal rats and aggravated the respiratory insufficiency associated with acute pancreatitis in which the mortality rate increased to 60%. This pulmonary oedema was not mediated by cardiac failure or by pulmonary hypertension.. Co-administration of pharmacological doses of pentoxifylline and thiopental caused pulmonary oedema and death in rats. Consequently, pentoxifylline should not be administered when anaesthesia is induced with thiopental to avoid any possible risk of acute pulmonary oedema and death in humans.

Topics: Acute Disease; Anesthetics, Intravenous; Animals; Drug Interactions; Injections, Intraperitoneal; Male; Pancreatitis; Pentoxifylline; Pulmonary Edema; Rats; Rats, Wistar; Thiopental; Vasodilator Agents

This study was designed to investigate the possible participation of urethane, pentobarbital sodium and thiopental sodium anaesthesia in the lung oedema induced by alpha-naphthylthiourea (ANTU), which is a well known noxious chemical agent in the lung. ANTU when injected intraperitoneally (i.p.) into rats (10 mg x kg (-1) i.p.) produced lung oedema as indicated by an increase in lung weight/body weight (LW/BW) ratio and pleural effusion (PE) reaching a maximum within 4 h. Administration of urethane prior to ANTU, at doses of 100 and 200mg(100g)(-1), elicited a significant and dose-dependent inhibition in LW/BW ratio and PE. Thiopental sodium at doses of 25, 50 mg x kg (-1), also produced a significant and dose-dependent inhibition of both parameters. Prior i.p. injection of pentobarbital sodium at a dose of 40 mg x kg (-1) elicited a significant inhibition in both parameters. These results suggest that i.p. urethane, thiopental sodium and pentobarbital sodium pretreatment have a prophylactic effect on ANTU-induced lung injury in rats. The possible role of the anaesthetics in lung oedema induced by ANTU and the possible underlying mechanisms are discussed.

Topics: Animals; Hypnotics and Sedatives; Male; Organ Size; Pentobarbital; Pleural Effusion; Pulmonary Edema; Rats; Thiopental; Thiourea; Urethane

Six children who remained in deep coma after immersion accidents in fresh water received therapy to maintain normal intracranial pressure (ICP). This involved controlled ventilation to ensure hypocapnia and hyperoxaemia, maintenance of low normothermia, fluid restriction, dexamethasone (1-1.5 mg/kg initially, 1-1.5 mg/kg/day as maintenance) and barbiturates (phenobarbitone and thiopentone). The latter were given in a wide range of dosage. Increased ICP was common to all patients, but could always be kept at acceptable levels. All patients suffered from pulmonary oedema; three developed broncho-pneumonia and two developed adult respiratory distress syndrome. All children survived with good recovery, two needed active rehabilitation for several months.

Topics: Accidents; Child; Child, Preschool; Coma; Critical Care; Female; Fresh Water; Humans; Hypothermia, Induced; Immersion; Infant; Intracranial Pressure; Male; Monitoring, Physiologic; Near Drowning; Phenobarbital; Pulmonary Edema; Resuscitation; Thiopental

Topics: Aged; Anesthesia, Inhalation; Anesthesia, Intravenous; Benperidol; Central Venous Pressure; Dihydroxyphenylalanine; Dopamine Antagonists; Electrocardiography; Fentanyl; Fractures, Bone; Hip; Humans; Injections, Intravenous; Male; Nitrous Oxide; Parkinson Disease; Pulmonary Edema; Pulse; Succinylcholine; Thiopental

Topics: Acidosis; Adolescent; Adult; Anesthesia; Anesthetics; Female; Halothane; Heart Arrest; Humans; Kidney Transplantation; Male; Middle Aged; Nitrous Oxide; Oxygen; Pulmonary Edema; Succinylcholine; Thiopental; Transplantation, Homologous; Tubocurarine; Vomiting

Topics: Adolescent; Adult; Anesthetics, Local; Atropine; Barbiturates; Child; Child, Preschool; Cyclopropanes; Epinephrine; Female; Halothane; Humans; Iatrogenic Disease; Male; Middle Aged; Narcotics; Postoperative Complications; Pulmonary Edema; Thiopental

Topics: Adult; Aortic Valve Stenosis; Blood Gas Analysis; Humans; Male; Mitral Valve Stenosis; Oximetry; Pleural Effusion; Pulmonary Edema; Radiography; Thiopental

Topics: Abdomen; Adjuvants, Anesthesia; Analgesics; Anesthesia, General; Blood Pressure; Chlorpromazine; Curare; Female; Heart; Heart Diseases; Humans; Hypotension; Isonipecotic Acids; Meperidine; Methoxyflurane; Nitrous Oxide; Phenoperidine; Positive-Pressure Respiration; Postoperative Care; Preanesthetic Medication; Pulmonary Edema; Respiratory Tract Diseases; Thiopental; Thoracic Surgery; Thorax

Topics: Adult; Anesthesia, General; Apnea; Bicarbonates; Decamethonium Compounds; Fever; Heart Massage; Humans; Isoproterenol; Male; Metaraminol; Methamphetamine; Pulmonary Atelectasis; Pulmonary Edema; Spasm; Succinylcholine; Thiopental

Topics: Adolescent; Anesthesia; Anuria; Child; Heart Arrest; Heart Massage; Humans; Hydropneumothorax; Kidneys, Artificial; Pleural Effusion; Pulmonary Edema; Respiration, Artificial; Respiratory Insufficiency; Thiopental; Toxicology

Topics: Abortion, Therapeutic; Anesthesia; Anesthesia, Endotracheal; Curare; Female; Genital Neoplasms, Female; Geriatrics; Gynecology; Heart Failure; Humans; Hypoxia; Hysterectomy; Iatrogenic Disease; Mortality; Postoperative Complications; Preanesthetic Medication; Pregnancy; Pregnancy, Tubal; Preoperative Care; Pulmonary Edema; Statistics as Topic; Succinylcholine; Surgical Procedures, Operative; Switzerland; Thiopental; Toxicology