The latest pharmacologic ventilator.
The latest pharmacologic ventilator.
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最新的药理呼吸机。
DOI：
10.1097/aln.0000000000000368
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发表时间：
2014
期刊：
影响因子：
8.8
通讯作者：
Cotten,JosephF
中科院分区：
文献类型：
--
作者：
Cotten,JosephF
作为麻醉师，我们经常使用会损害患者呼吸能力的药物，处理后果可能是一个挑战。然而，我们的工作可能会变得更容易。在本期中，Roozekrans 等人。介绍了两项在荷兰对男性志愿者进行的小型人体研究，研究对象是 Galleon Pharmaceuticals（宾夕法尼亚州霍舍姆）正在开发的一种有前景的新型呼吸刺激化合物 GAL021。 1 在比利时进行的 GAL021 的其他首次人体安全性和药代动力学研究将发表在即将出版的《英国麻醉杂志》上。阿片类药物是治疗急性疼痛最有效的药物。然而，它们会引起阿片类药物诱导的呼吸抑制（OIRD），这是许多不良围手术期呼吸事件的重要原因。 2阿片类药物敏感性是不可预测的，并受到多种药物、年龄和合并症（包括肥胖和睡眠呼吸暂停）的影响。阿片类药物与镇痛剂一起会导致镇静、通气不足、对缺氧和高碳酸血症的反应能力丧失、呼吸不规律并伴有呼吸暂停以及上呼吸道肌张力丧失。最小化 OIRD 的药物将具有重要的临床实用性。纳洛酮对于逆转 OIRD 是有效、可靠且广泛使用的，但不幸的是，它也会逆转镇痛作用。 GAL021 正在开发作为治疗 OIRD 的药物，但对阿片类药物镇痛没有影响。
As anesthesiologists, we routinely administer drugs that compromise a patient's ability to breathe, and dealing with the consequences can be a challenge. However, our jobs may be getting easier. In this issue, Roozekrans et al. present two small, human studies on male volunteers conducted in The Netherlands on a promising new breathing stimulant compound, GAL021, being developed by Galleon Pharmaceuticals (Horsham, PA). 1Additional first-in-human safety and pharmacokinetic studies of GAL021 conducted in Belgium are to be published in an upcoming issue of the British Journal of Anaesthesia.Opioids are the most effective drugs for acute pain management. However, they cause opioid induced respiratory depression (OIRD), which is a significant contributor to many adverse perioperative respiratory events. 2Opioid sensitivity is unpredictable and impacted by polypharmacy, age, and co-morbidities including obesity and sleep apnea. Opioids, along with analgesia, cause sedation, hypoventilation, loss of responsiveness to hypoxia and to hypercapnia, irregular breathing with periods of apnea, and loss of upper airway muscle tone. A drug that minimizes OIRD would have significant clinical utility. Naloxone is effective, reliable, and widely-available to reverse OIRD, but, unfortunately, it reverses analgesia, as well. GAL021 is being developed as an agent to treat OIRD with no effect on opioid analgesia.