Document Detail


Delayed administration of inhaled nitric oxide preserves alveolar-capillary membrane integrity in porcine gram-negative sepsis.
MedLine Citation:
PMID:  9006555     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the effect of delayed administration of inhaled nitric oxide (NO) on acute lung injury after the onset of gram-negative sepsis. DESIGN: Nonrandomized controlled study. SETTING: University medical center laboratory. SUBJECTS: Yorkshire swine. INTERVENTIONS: Five groups of swine were anesthetized, mechanically ventilated, and studied for 5 hours. After surgical preparation, control (n = 10) and NO-treated control (n = 6) animals received a 1-hour infusion of sterile saline solution. Sepsis was induced with a 1-hour intravenous infusion of live Pseudomonas aeruginosa. Untreated animals with sepsis (n = 10) received no treatment. Inhaled NO at 20 ppm was administered to NO30-treated animals with sepsis (n = 7) and NO60-treated animals with sepsis (n = 8) beginning at 30 and 60 minutes after bacterial infusion was begun, respectively. MAIN OUTCOME MEASURES: Systemic and pulmonary hemodynamics, arterial blood gas determination, bronchoalveolar lavage protein and neutrophil content, neutrophil oxidant burst, lung myeloperoxidase content, and scanning electron micrographic studies. RESULTS: A progressive, significant (P < .05) decline in PaO2 developed in untreated animals with sepsis, which was prevented in NO30- and NO60-treated animals with sepsis. A significant (P < .05) increase in bronchoalveolar lavage protein and neutrophil counts compared with baseline values was observed in untreated animals with sepsis, indicating acute lung injury. These variables exhibited no notable increase in NO30- and NO60-treated animals with sepsis and were significantly (P < .05) reduced compared with untreated animals with sepsis. The lung myeloperoxidase content was significantly (P < .05) elevated at 5 hours in all groups with sepsis compared with baseline values and the control and NO-treated control groups. The total phorbol myristate acetate-induced polymorphonuclear leukocyte oxidant burst at 5 hours was significantly (P < .05) decreased in the NO30- and NO60-treated animals with sepsis compared with untreated animals with sepsis. Untreated and NO30- and NO60-treated animals with sepsis showed a significant (P < .05) increase in pulmonary artery pressure at 30 minutes, followed by a progressive decline. These changes were significant (P < .05) compared with baseline values and the control groups. No significant (P < .05) difference in pulmonary artery pressure or systemic arterial pressure was found at any time between untreated and NO30- and NO60-treated animals with sepsis. CONCLUSIONS: The delayed administration of inhaled NO preserves alveolar-capillary membrane integrity in this porcine model of gram-negative sepsis. The inhibition of neutrophil transendothelial migration, rather than neutrophil rolling or tight adhesion, may be a critical mechanism by which inhaled NO produces this effect. Decreased oxidant production by activated neutrophils may be a secondary mechanism by which inhaled NO reduces acute lung injury.
Authors:
G L Bloomfield; L B Sweeney; B J Fisher; C R Blocher; M M Sholley; H J Sugerman; A A Fowler
Related Documents :
10588605 - Changes in collagen turnover in early acute respiratory distress syndrome.
17381535 - Effects of pmx-dhp treatment for patients with directly induced acute respiratory distr...
10738015 - Improvement in respiratory compliance after surfactant therapy evaluated by a new method.
9575985 - Direct fetal glucocorticoid treatment alters postnatal adaptation in premature newborn ...
22378035 - Masked hypertension and prehypertension: diagnostic overlap and interrelationships with...
10376255 - Diversity of response of optic nerve head circulation to timolol maleate in gel-forming...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  132     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-02-24     Completed Date:  1997-02-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  65-75     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Blood-Air Barrier / drug effects*
Gram-Negative Bacterial Infections / physiopathology*
Hemodynamics / drug effects
Lung / chemistry,  ultrastructure
Neutrophils / drug effects,  physiology
Nitric Oxide / pharmacology*
Peroxidase / analysis
Pulmonary Circulation / drug effects
Sepsis / physiopathology*
Swine
Time Factors
Chemical
Reg. No./Substance:
10102-43-9/Nitric Oxide; EC 1.11.1.7/Peroxidase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Shotgun wounds in children. Not just accidents.
Next Document:  Enterococcal bacteremia in the surgical intensive care unit. Does vancomycin resistance affect morta...