Evaluation efficacy of Tadalafil and Bosentan on pulmonary arterial pressure, cardiac outupt and prognosis of mechanical ventilation in COPD patients with pulmonary hypertenion under mechanical ventilation

Abstract

The favorable effect of drugs such as tadalafil and bosentan on right heart hemodynamics in pulmonary hypertension in patients with exacerbation of chronic obstructive pulmonary disease under mechanical ventilation mainly increases cardiac output by increasing left ventricular preload. It is statistically valuable; Therefore, the present study was performed to evaluate the effect of these therapeutic agents (tadalafil and bosentan) on pulmonary hypertension in COPD patients under mechanical ventilation. Materials and Methods: This study is a randomized clinical trial that was performed during 2016 and 2017 in Imam Reza Hospital (affiliated to Tabriz University of Medical Sciences) with the participation of 200 patients diagnosed with COPD and high pulmonary artery pressure. After randomly assigning the patients to the two groups, Bosentan was given 125 mg twice daily for the bosentan group and 40 mg once daily for the tadalfil group; Before and after the intervention, impact volume, left ventricular and pulmonary artery pressure were measured and compared. Descriptive and inferential statistics were used to compare the variables between the two groups. P value less than 0.05 was considered significant. Results: The effectiveness of both drugs in reducing pulmonary artery pressure was significant; But in the comparison between groups after the intervention, it was shown that there was no statistically significant difference between the two groups; On the other hand, both drugs had significant effects on the improvement of FEV1, PaO2 and PaCO2; However, there was no statistically significant difference between the two groups in the duration of mechanical ventilation and the number of people with successful ventilation.