[Therapy of acute lung failure with nifedipine. A study with interventional analysis]

In 24 patients with severe ARDS after major gastro-intestinal surgery the effect of the calcium antagonist nifedipine on pulmonary function was investigated. Besides descriptive statistics and comparison between group means, intervention analysis was employed to assess the treatment effect for the individual patient. The treatment effect could always be assessed after 12 hours. 14 out of 15 patients with initially high PVR showed a significant decrease of PVR followed by an improvement of AaDO2. 8 out of 9 patients with initially normal PVR did not improve in pulmonary function as no significant changes in PVR occurred. No unwanted side-effects on cardio-vascular function (MAP, CI, LVSWI, RVSWI) could be observed. 9 out of 24 patients decreased. Lethality among patients who showed a significant decrease of PVR under nifedipine infusion was 3 out of 15, whereas 5 out of 9 patients died without changes in PVR. Thus nifedipine can improve pulmonary function in ARDS. Especially in the early stages of ARDS with elevated PVR the administration of nifedipine p.i. appears advantageous.