ArticleNagoya journal of medical science2026
Hypoxemia with atelectasis during clazosentan therapy after subarachnoid hemorrhage: a potential effect of suppressed hypoxic pulmonary vasoconstriction.
Article in Nagoya journal of medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Clazosentan, a selective endothelin-A (ET-A) receptor antagonist, is used to prevent cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH). Although pulmonary edema and fluid retention are recognized adverse effects, hypoxemia associated with atelectasis has not been described. Endothelin-1 contributes to hypoxic pulmonary vasoconstriction (HPV), which preserves ventilation-perfusion (V/Q) matching by diverting blood flow from poorly ventilated regions; pharmacologic ET-A blockade may attenuate HPV, increasing intrapulmonary shunt and impairing oxygenation. We report a man in his 60s with aneurysmal SAH (World Federation of Neurosurgical Societies [WFNS] I, Fisher 3) who underwent clipping surgery and postoperative clazosentan infusion (10 mg/h, standard Japanese dosage). On day 7 of infusion, hypoxemia (SpO
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