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Titolo:
THE EFFECTS OF NITRIC-OXIDE INHALATION ON RESPIRATORY MECHANICS AND GAS-EXCHANGE DURING ENDOTOXEMIA IN THE PIG
Autore:
DAHM PL; JONSON B; DEROBERTIS E; MYHRE E; SVANTESSON C; THORNE J; BLOMQUIST S;
Indirizzi:
UNIV LUND HOSP,INST EXPT SURG,DEPT ANAESTHESIA & INTENS CARE S-22185 LUND SWEDEN UNIV LUND HOSP,INST EXPT SURG,DEPT CLIN PHYSIOL S-22185 LUND SWEDEN UNIV LUND HOSP,INST EXPT SURG,DEPT INFECT DIS S-22185 LUND SWEDEN UNIV LUND HOSP,INST EXPT SURG,DEPT SURG S-22185 LUND SWEDEN
Titolo Testata:
Acta anaesthesiologica Scandinavica
fascicolo: 5, volume: 42, anno: 1998,
pagine: 536 - 544
SICI:
0001-5172(1998)42:5<536:TEONIO>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
SINGLE BREATH TEST; PULMONARY-HYPERTENSION; DISTRESS-SYNDROME; CARBON-DIOXIDE; LUNG INJURY; SHOCK; PRESSURE; BRONCHOCONSTRICTION; PROSTACYCLIN; PLATELETS;
Keywords:
NITRIC OXIDE; PULMONARY; DEAD SPACE; COMPLIANCE; RESPIRATORY MECHANICS; GAS EXCHANGE; ENDOTOXIN; SEPSIS; SHOCK;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
36
Recensione:
Indirizzi per estratti:
Citazione:
P.L. Dahm et al., "THE EFFECTS OF NITRIC-OXIDE INHALATION ON RESPIRATORY MECHANICS AND GAS-EXCHANGE DURING ENDOTOXEMIA IN THE PIG", Acta anaesthesiologica Scandinavica, 42(5), 1998, pp. 536-544

Abstract

Background: Ln the adult respiratory distress syndrome, nitric oxide (NO) inhalation improves oxygenation through reducing ventilation-perfusion mismatching, but detailed information on the pulmonary effects of NO inhalation in septic shock is scarce. The present study investigated the effects of inhaled NO on alveolar dead space (Vdalv) and venous admixture as well as on respiratory system compliance (Crs) and respiratory system resistance (Rrs) in a porcine model of septic shock. Protective effects of NO are discussed. Methods: Thirteen anaesthetised and ventilated pigs were given an infusion of endotoxin for an observation time of 220 min to induce acute lung injury (ALI). In the NO-early group (n=6), an inhalation of 60 ppm NO was started simultaneously with the endotoxin infusion and continued for 190 min. In 7 control/NO-late animals, 60 ppm NO was administered for 30 min following 190 min of endotoxin infusion. Haemodynamics, single-breath CO2-, pressure-, and now signals were recorded. Results: Endotoxin induced haemoconcentration, pulmonary vasoconstriction, and a decrease in Crs, while venousadmixture, Vdalv, and Rrs increased. Ln the NO-early group, the pulmonary vasoconstriction was attenuated, no increase in pulmonary venous admixture or in Vdalv was seen before cessation of NO, and the improvements in oxygenation outlasted the NO inhalation. In the control/NO-late group, the NO inhalation reversed the changes in dead space and venous admixture. NO had no effect on the changes in respiratory mechanics. Conclusion: In porcine ALI, 60 ppm NO diminishes pulmonary vasoconstriction and improves gas exchange by reducing pulmonary venous admixture and alveolar dead space, but does not prevent a fall in Crs. NO inhalation may help prevent longlasting pulmonary failure.

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Documento generato il 30/11/20 alle ore 16:10:02