Combined effect of low-dose nitric oxide gas inhalation with partial liquid ventilation on hemodynamics, pulmonary function, and gas exchange in acute lung injury of newborn piglets.
We conducted a randomized animal study to determine whether there is a cumulative effect on hemodynamics, pulmonary function, and gas exchange when low-dose nitric oxide (NO) is added to partial liquid ventilation (PLV) in acute lung injury. Eighteen newborn piglets were saline-lavaged repeatedly, and randomly divided into two groups: PLV with perfluorocarbon group (n=8) and lavage only (control) group (n=10). Perfluorodecalin (30 mL/kg) was instilled into the endotracheal tube for 30 min, followed by 5-10 mL/kg/hr. Fifteen minutes after the completion of perfluorodecalin dosing, NO (10 ppm) was added to the inspiratory gas in an "on/off" manner. Perfluorodecalin instillation produced a significant improvement in gas exchange, pulmonary mechanics, shunt, and pulmonary arterial pressure (PAP). The addition of NO produced a further significant improvement in PaO2 and PAP. The "on/off" response to NO was seen apparently in PAP, PaO2, dynamic compliance, and shunt. All the variables in control group were remained at near the after-lavage levels without significant improvements until the end of the experiment. We concluded that NO might have a cumulative effect on gas exchange when combined with PLV, and this might be attributable to deceased PAP and V/Q mismatching.
Choi
Chang Won
CW
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Hwang
Jong Hee
JH
Chang
Yun Sil
YS
Park
Won Soon
WS
D000280:Administration, Inhalation; D000818:Animals; D000831:Animals, Newborn; D005466:Fluorocarbons / Q000378:metabolism; D006439:Hemodynamics; D021061:Liquid Ventilation; D009569:Nitric Oxide / Q000008:administration & dosage / Q000378:metabolism*; D010952:Plasma Substitutes / Q000378:metabolism; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D011897:Random Allocation; D012128:Respiratory Distress Syndrome; D015656:Respiratory Mechanics; D012143:Respiratory Physiological Phenomena; D013552:Swine
D005466:Fluorocarbons; D010952:Plasma Substitutes; D009569:Nitric Oxide; C008805:perfluorodecalin