Adenosine Induced Bronchospasm . Anes R3 鄭淳心. Case report:. 病歷號 : 4129285 姓名 : 張德 X 身高 : 169.5cm 體重 : 60 Kgw 年齡 : 62 y/o 性別 : M 科別 : SURG-chest. Lab.data 1:. WBC 10.1 K/μL RBC 5.06 M/μL HB 14.0 g/dL HCT 44.2 % PLT186.0 K/μL Alb 3.9 g/dL TP 6.1 g/dL PT, PTT :WNL.
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Anes R3 鄭淳心
病歷號 : 4129285
姓名 : 張德X
身高 : 169.5cm
體重 : 60 Kgw
年齡 : 62 y/o
性別 : M
科別 : SURG-chest
NORMAL SINUS RHYTHM, RATE 84 -- normal P axis, PR, rate & rhythm
COPD with emphysema; large bullae in the RML.
VATS for Wedge resection
EKG was returned to sinus rhythm
PATIENTS AND METHODS:
A total of 122 consecutive patients (75 male, 47 female; mean age 59 years, SD 10 years) undergoing pharmacologic stress testing with an intravenous infusion of adenosine also had volume-flow spirometry (Vitalograph Compact, Vitalograph Ltd) before, during, and after the test. The indices assessed were forced expiratory volume in one second, its ratio to the forced vital capacity, and peak expiratory flow rate.
Mild to severe symptoms were experienced by 81% of patients during adenosine infusion. More than half the patients had dyspnea, but there was no associated bronchospasm. Although the patients with COPD showed parameters indicative of bronchial resistance compared with those without this problem, there was no further deterioration after adenosine infusion. Similarly, patients with a history of tobacco abuse, despite showing a tendency toward increasing airways resistance, had no bronchospasm during the administration of adenosine.
This study shows that adenosine can be safely administered intravenously to selected patients with known or suspected COPD to produce coronary vasodilatation for myocardial perfusion imaging. Patients who are within the guidelines established for this study should be considered for adenosine coronary vasodilatation with use of bronchodilator pretreatment, a graduated dose of adenosine, and regular chest auscultation during the infusion. Mayo Clinic Proceedings. 74(4):339-46, 1999 Apr.
Journal of Asthma. 37(5):435-40, 2000 Aug.