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Evaluation of Almitrine Infusion During Veno-Venous Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome in Adults

Esnault, Pierre MD*,†; Hraiech, Sami MD, PhD*; Bordes, Julien MD; Forel, Jean-Marie MD, PhD*; Adda, Mélanie MD*; Rambaud, Romain MD*; Lehingue, Samuel MD*; Roch, Antoine MD, PhD*,‡; Papazian, Laurent MD, PhD*; Guervilly, Christophe MD*

doi: 10.1213/ANE.0000000000002786
Critical Care and Resuscitation

This single-center case series investigated the effect of almitrine infusion on Pao2/fraction of inspired oxygen (Fio2) in 25 patients on veno-venous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. A positive trial was defined as an increase of Pao2/Fio2 ratio ≥20%. Thirty-two trials were performed. Twenty (62.5%, 95% confidence interval, 37.5%–75%) trials in 18 patients were positive, with a median Pao2/Fio2 ratio increase of 35% (25%–43%). A focal acute respiratory distress syndrome and inhaled nitric oxide therapy were more frequent in patients with a positive response to almitrine. We observed no complications of almitrine use.

From the *Medical Intensive Care Unit, Respiratory Distress and Severe Infections, Nord Hospital, URMITE CNRS-UMR 6236, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France

Intensive Care Unit, Sainte Anne Military Hospital, Toulon, France

Department of Emergency, Nord Hospital, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France.

Published ahead of print 28 November 2017.

Accepted for publication November 28, 2017.

Funding: None.

The authors declare no conflicts of interest.

The study was approved by the Ethics Review Board of the French Language Society of Critical Care Medicine (CE SRLF17-05). The Ethics Committee approved the study and waived the requirement for informed consent from the patients or patient’s kin given the observational and retrospective nature of the study.

Reprints will not be available from the authors.

Address correspondence to Pierre Esnault, MD, Service de Réanimation, Hôpital d’Instruction des Armées Sainte Anne, Blvd Sainte Anne, 83000 Toulon France. Address e-mail to

Copyright © 2018 International Anesthesia Research Society
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