Effects of combined high-dose partial liquid ventilation and almitrine on pulmonary gas exchange and hemodynamics in an animal model of acute lung injury.
OBJECTIVE
To determine possible additive effects of combined high-dose partial liquid ventilation (PLV) and almitrine bismesylate (ALM) on pulmonary gas exchange and hemodynamics in an animal model of acute lung injury (ALI).


METHODS
Prospective, controlled animal study in an animal research facility of a university hospital.


METHODS
ALI was induced in 12 anesthetized and mechanically ventilated pigs by repeated wash-out of surfactant. After initiation of PLV with 30 ml/kg perfluorocarbon the animals were randomly assigned to receive either accumulating doses of ALM (0.5, 1.0, 2.0, 4.0, 8.0, and 16.0 micrograms/kg per minute) for 30 min each (n = 6) or the solvent malic acid (n = 6).


RESULTS
Pulmonary gas exchange and hemodynamics were measured at the end of each infusion period. Compared to ALI, PLV alone significantly increased arterial oxygen partial pressure (PaO2) and decreased venous admixture (QVA/QT) and mean pulmonary artery pressure (MPAP). Administration of ALM did not result in a further improvement in PaO2, QVA/QT or MPAP compared to PLV alone but decreased PaO2 and increased QVA/QT and MPAP when 16 micrograms/kg per min ALM was compared to PLV alone.


CONCLUSIONS
In an animal model of surfactant depletion induced ALI the combined treatment of PLV and ALM induced no significant improvement in pulmonary gas exchange or hemodynamics when compared to PLV alone. Moreover, high-dose ALM significantly impaired gas exchange and pulmonary hemodynamics.
Sommerer
A
A
Klinik für Anästhesiologie, Universitätsklinikum, RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
Dembinski
R
R
Max
M
M
Kuhlen
R
R
Kaisers
U
U
Rossaint
R
R
D015765:Almitrine / Q000008:administration & dosage* / Q000494:pharmacology; D000818:Animals; D001784:Blood Gas Analysis; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D004353:Drug Evaluation, Preclinical; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005466:Fluorocarbons / Q000008:administration & dosage* / Q000494:pharmacology; D006439:Hemodynamics / Q000187:drug effects*; D006842:Hydrocarbons, Brominated; D021061:Liquid Ventilation / Q000379:methods*; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange / Q000187:drug effects*; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D011897:Random Allocation; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy*; D019141:Respiratory System Agents / Q000008:administration & dosage* / Q000494:pharmacology
D005466:Fluorocarbons; D006842:Hydrocarbons, Brominated; D019141:Respiratory System Agents; D015765:Almitrine; C003072:perflubron