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Titolo:
Effects of NO inhalation on pulmonary leukocyte sequestration and blood volume in porcine endotoxaemia
Autore:
Dahm, PL; Blomquist, S; De Robertis, E; Jonson, B; Myhre, E; Svantesson, C; Thorne, J;
Indirizzi:
Univ Lund Hosp, Dept Anesthesiol, Fac Med, S-22185 Lund, Sweden Univ Lund Hosp Lund Sweden S-22185 hesiol, Fac Med, S-22185 Lund, Sweden Univ Lund Hosp, Dept Intens Care, Fac Med, S-22185 Lund, Sweden Univ Lund Hosp Lund Sweden S-22185 s Care, Fac Med, S-22185 Lund, Sweden Univ Lund Hosp, Dept Clin Physiol, Fac Med, S-22185 Lund, Sweden Univ LundHosp Lund Sweden S-22185 hysiol, Fac Med, S-22185 Lund, Sweden Univ Lund Hosp, Dept Infect Dis, Fac Med, S-22185 Lund, Sweden Univ Lund Hosp Lund Sweden S-22185 ct Dis, Fac Med, S-22185 Lund, Sweden Univ Lund Hosp, Dept Surg, Fac Med, S-22185 Lund, Sweden Univ Lund Hosp Lund Sweden S-22185 t Surg, Fac Med, S-22185 Lund, Sweden
Titolo Testata:
INTENSIVE CARE MEDICINE
fascicolo: 3, volume: 26, anno: 2000,
pagine: 336 - 343
SICI:
0342-4642(200003)26:3<336:EONIOP>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
NITRIC-OXIDE INHALATION; RESPIRATORY-DISTRESS-SYNDROME; NEUTROPHIL SEQUESTRATION; GAS-EXCHANGE; LUNG; ADHESION; PLATELET; INFLAMMATION; HYPERTENSION; ENDOTOXEMIA;
Keywords:
nitric oxide; leukocyte sequestration; sepsis; endotoxin; shock; lung; oxygenation; pulmonary vasoconstriction; blood volume; circulation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Dahm, PL Univ Lund Hosp, Dept Anesthesiol, Fac Med, S-22185 Lund, Sweden Univ Lund Hosp Lund Sweden S-22185 ac Med, S-22185 Lund, Sweden
Citazione:
P.L. Dahm et al., "Effects of NO inhalation on pulmonary leukocyte sequestration and blood volume in porcine endotoxaemia", INTEN CAR M, 26(3), 2000, pp. 336-343

Abstract

Objective: Sequestration and mil:ration of activated neutrophils plays a major role in the pulmonary injury typical of septic shock and the adult respiratory distress syndrome. Inhaled NO may counteract alveolar-capillary damage attributed to activated neutrophils. The present study describes a method to directly demonstrate the effects of NO inhalation on endotoxin-induced sequestration of (99)mTc-labelled leukocytes [A(s)(t)] in the lungs of pigs. Design: Prospective controlled study. Setting: Laboratory for experimental surgery at a university medical centre. Subjects: Anaesthetised and ventilated pigs. Interventions: To induce inflammatory shock 26 animals received a continuous endotoxin infusion. Thirteen animals inhaled NO from the start of the experiments, while 13 served as controls. In 13 animals from both groups, leukocytes were labelled in vitro and reinjected, while hi the 13 others erythrocytes were labelled in vivo to provide corrections for changes in blood volume. Measurements and results: The pulmonary distribution of Tc-99m-la-belied leukocytes or erythrocytes was studied dynamically for 180 min, After correction for changes in pulmonary and heart blood volume (PBV, HBV), leukocyte sequestration curves were generated. Endotoxin induced pulmonary vasoconstriction, reduced PBV, impaired oxygenation, and caused a maximum increase inA(s)(t) of 30 % in the lungs. NO inhalation attenuated pulmonary vasoconstriction and the reduction in PBV. The maximum increase in A(8)(t) was reduced to 15 % of baseline. Conclusions: Inhaled NO exerts its main vascular effects in the pulmonary microvasculature, the primary site of physiological neutrophil margination and pathological adhesion of activated leukocytes. Early use of NO inhalation may offer protection against the development of more lasting pulmonary failure in septic shock by reducing leukocyte sequestration in the lungs.

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Documento generato il 01/12/20 alle ore 08:17:40