Pulmonary vascular response to digoxin in newborn lambs

Jay M Milstein, B. W. Goetzman

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

The effects of digoxin on pulmonary vascular resistance (PVR) were evaluated in normoxic (N) and hypoxic (H) newborn lambs with normal and elevated PVR, respectively. Lambs were anesthetized and instrumented to enable continuous measurement of mean pulmonary arterial pressure (P(PA)), mean left atrial pressure (P(LA)), mean pulmonary blood flow (Q(p)), and mean aortic pressure (P(Ao)). Digoxin (10-20 μg/kg) was injected via central venous catheters in 11 N lambs and 4 H lambs. Under N conditions, baseline PVR was equal to 0.12 mm Hg/ml/min/kg, P(PA) was 33 mm Hg, P(LA) was 6 mm Hg, Q(p) was 235 ml/min/kg, and P(Ao) was 69 mm Hg. Following digoxin, mean PVR increased by 24% (P < 0.001) and P(PA) increased by 23% (P < 0.001) for an average duration of 199 sec while Q(p) increased by 5% (P < 0.02) and P(LA) was constant suggesting a direct vasoconstrictive effect. Under H conditions, baseline PVR was equal to 0.26 mm Hg/ml/min/kg, P(PA) was 58 mm Hg, P(LA) was 4 mm Hg, Q(p) was 208 ml/min/kg, and P(Ao) was 65 mm Hg. Following digoxin, mean PVR, Q(p), P(LA), and P(Ao) did not change appreciably although P(PA) had a uniform increase of 5% (P < 0.001). The blunted response may suggest that either the pulmonary vascular bed was maximally constricted or that digoxin and hypoxia share a common mechanism. In conclusion, digoxin has a direct pulmonary vasoconstrictor action in newborn lambs. Because of its short duration, this action probably should not alter the clinical use of this drug in newborn humans.

Original languageEnglish (US)
Pages (from-to)223-229
Number of pages7
JournalPediatric Pharmacology
Volume4
Issue number4
StatePublished - 1984

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

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