Ibuprofen plus prostaglandin E1 in a septic porcine model of adult respiratory distress syndrome.
Prostaglandin manipulation has been shown to improve pulmonary dysfunction in animal models of acute respiratory distress syndrome. Using our previously reported porcine model of Pseudomonas-induced respiratory failure, we examined the therapeutic effects of a vasodilating prostaglandin, PGE1, and a reversible cyclooxygenase inhibitor, ibuprofen. Forty-two animals were randomized to seven groups: I--ibuprofen; II--PGE1; III--ibuprofen + PGE1; IV--Pseudomonas + ibuprofen; V--Pseudomonas + PGE1; VI--Pseudomonas + ibuprofen + PGE1; VII--Pseudomonas. Ibuprofen significantly improved pulmonary vasoconstriction, pulmonary hypertension, and hypoxemia, as well as increased survival slightly. PGE1 had no effect on pulmonary dysfunction, but prevented the rise in systemic vascular resistance that occurred in untreated, infected animals and animals treated with ibuprofen alone. Combination therapy improved stroke volume index, a measure of nonpulmonary organ function.
Davies
E A
EA
Department of Surgery, Ohio State University College of Medicine, Columbus.
Campbell
A J
AJ
Devine
M J
MJ
Steinberg
S M
SM
Cloutier
C T
CT
D000527:Alprostadil / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D006439:Hemodynamics; D007052:Ibuprofen / Q000008:administration & dosage / Q000627:therapeutic use*; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000503:physiopathology; D011550:Pseudomonas aeruginosa; D011897:Random Allocation; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D013318:Stroke Volume / Q000187:drug effects; D013552:Swine; D014655:Vascular Resistance / Q000187:drug effects
D000527:Alprostadil; D007052:Ibuprofen