Peritoneal ventilation in rabbits: augmentation of gas exchange with cisapride.
BACKGROUND
Peritoneal ventilation has been shown to be effective in achieving extrapulmonary oxygenation and carbon dioxide elimination in an animal model of severe adult respiratory distress syndrome (ARDS). Cisapride is a "prokinetic" agent (increases gastric emptying), that may increase the splanchnic circulation and thus favourably affect gas exchange in peritoneal ventilation.


METHODS
Using Doppler ultrasound the effect of cisapride on the portal venous circulation was examined in eight spontaneously breathing rabbits and the effect of cisapride on gas exchange in five rabbits spontaneously breathing room air was compared with that of a control group who did not receive cisapride. Its effect on gas exchange in five rabbits with ARDS being treated with mechanical lung and peritoneal ventilation was compared with that of a control group, and its effect on gas exchange in five rabbits with ARDS treated with conventional ventilation was also compared with that of a control group.


RESULTS
Enteral administration of cisapride increased portal venous blood velocity, as measured ultrasonographically, by a mean of 188% one hour after receiving the drug. In rabbits with ARDS being treated with both peritoneal ventilation and mechanical ventilation to the lungs, those receiving cisapride had arterial oxygen tensions 1.5-3 times that of controls. Cisapride had no effect on arterial blood gas tensions in rabbits who were spontaneously breathing room air, nor in rabbits with ARDS who received only conventional mechanical lung ventilation.


CONCLUSIONS
Cisapride increases arterial oxygenation in rabbits with severe ARDS treated with peritoneal ventilation, probably due to its ability to increase splanchnic circulation. It should be considered as an adjuvant medication to peritoneal ventilation.
Barr
J
J
Department of Pediatric Intensive Care, Assaf Harofeh Medical Center, Zerifin, Israel.
Lushkov
G
G
Strauss
S
S
Gurevitch
S
S
Lahat
E
E
Bistritzer
T
T
Klin
B
B
Eshel
G
G
D000818:Animals; D001783:Blood Flow Velocity / Q000187:drug effects; D002245:Carbon Dioxide / Q000097:blood; D020117:Cisapride; D018592:Cross-Over Studies; D004195:Disease Models, Animal; D005746:Gastric Emptying / Q000187:drug effects*; D010100:Oxygen / Q000097:blood; D010537:Peritoneum; D010880:Piperidines / Q000627:therapeutic use*; D011817:Rabbits; D011897:Random Allocation; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D013152:Splanchnic Circulation / Q000187:drug effects*; D018608:Ultrasonography, Doppler
D010880:Piperidines; D002245:Carbon Dioxide; D010100:Oxygen; D020117:Cisapride