Improving survival by increasing lung edema clearance: is airspace delivery of dopamine a solution?
In this issue of Critical Care Chamorro-Marin and coworkers provide new evidence that dopamine instilled into airspaces is beneficial in a rat model of ventilator-induced lung injury. This study is important because it is the first to explore the effects of dopamine on survival, albeit short term. The delivery of dopamine into the airspaces in vivo is also novel and builds upon previous studies describing the mechanisms by which dopamine exerts its effect by upregulating active Na+ transport in the lungs. Dopamine appears to increase active Na+ transport via activation of amiloride-sensitive sodium channels and the basolateral Na+/K+-ATPase within minutes, and it has been shown to be effective in normal lungs and several models of lung injury. This information is relevant to current clinical trials exploring the effects of alveolar fluid clearance stimulation in patients with acute lung injury.
Jaitovich
Ariel
A
Division of Pulmonary and Critical Care Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Sznajder
Jacob Iasha
JI
D000818:Animals; D004298:Dopamine / Q000008:administration & dosage / Q000494:pharmacology*; D055370:Lung Injury; D008297:Male; D011654:Pulmonary Edema / Q000209:etiology / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D012121:Respiration, Artificial / Q000009:adverse effects*; D015996:Survival Rate; D014132:Trachea
D004298:Dopamine