Cs. Rayhrer et al., NITRIC-OXIDE POTENTIATES ACUTE LUNG INJURY IN AN ISOLATED RABBIT LUNGMODEL, The Annals of thoracic surgery, 65(4), 1998, pp. 935-938
Citations number
17
Categorie Soggetti
Surgery,"Cardiac & Cardiovascular System","Respiratory System
Background. The effect of inhaled nitric oxide (NO) treatment on pulmo
nary function in the setting of adult respiratory distress syndrome is
controversial. We examined the effect of inhaled NO on pulmonary func
tion in an isolated rabbit lung model of oleic acid (OA)-induced acute
lung injury. We hypothesized that NO would decrease pulmonary artery
pressure and improve oxygenation. Methods. Rabbit heart-lung blocks we
re isolated, flushed in vivo, harvested, and immediately perfused with
whole blood and ventilated with 50% oxygen (O-2). Pulmonary artery pr
essure was determined every 15 seconds for 60 minutes of perfusion. Ox
ygenation was determined by blood gas analysis of pulmonary venous eff
luent at 0, 20, 40, and 60 minutes after initiation of OA infusion. Ra
bbits were randomized into four study groups: saline control; OA contr
ol, which received a 20-minute infusion of 50% OA/ethanol solution; NO
treatment (20 ppm NO inhaled before OA infusion); and NO control, whi
ch underwent NO (20 ppm) pretreatment, followed by saline infusion. Pu
lmonary artery pressure, oxygenation (arteriovenous O-2 difference), c
ompliance, and wet/dry lung weight were determined. Results. Pretreatm
ent with NO caused significant increases in pulmonary artery pressure
(NO treatment versus NO control and saline control; no significant dif
ference between NO treatment group and OA control group), and did not
improve oxygenation in our model. Conclusions. Contrary to our hypothe
sis, pretreatment with NO potentiates acute lung injury in our isolate
d lung model. There was significant exacerbation of pulmonary hyperten
sion and no improvement in oxygenation. Further investigation of the p
ossible deleterious effects of NO in acute lung injury are needed, esp
ecially in the early acute phases of this process. (C) 1998 by The Soc
iety of Thoracic Surgeons.