Document Detail


Effectiveness of nitric oxide during spontaneous breathing in experimental lung injury.
MedLine Citation:
PMID:  20337573     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Inhaled nitric oxide (iNO) improves gas exchange in about 60% of patients with acute respiratory distress syndrome (ARDS). Recruitment of atelectatic lung areas may improve responsiveness and preservation of spontaneous breathing (SB) may cause recruitment. Accordingly, preservation of SB may improve effectiveness of iNO. To test this hypothesis, iNO was evaluated in experimental acute lung injury (ALI) during SB. In 24 pigs with ALI, effects of 10 ppm iNO were evaluated during controlled mechanical ventilation (CMV) and SB in random order. Preservation of SB was provided by 4 different modes: Unassisted SB was enabled by biphasic positive airway pressure (BIPAP), moderate inspiratory assist was provided by pressure support (PS) and volume-assured pressure support (VAPS), maximum assist was ensured by assist control (A/C). Statistical analysis did not reveal gas exchange improvements due to SB alone. Significant gas exchange improvements due to iNO were only achieved during unassisted SB with BIPAP (P <.05) but not during CMV or assisted SB. The authors conclude that effectiveness of iNO may be improved by unassisted SB during BIPAP but not by assisted SB. Thus combined iNO and unassisted SB is possibly most effective to improve gas exchange in severe hypoxemic ARDS.
Authors:
Rolf Dembinski; Nadine Hochhausen; Sandra Terbeck; Johannes Bickenbach; Frederik Stadermann; Rolf Rossaint; Ralf Kuhlen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Experimental lung research     Volume:  36     ISSN:  1521-0499     ISO Abbreviation:  Exp. Lung Res.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-26     Completed Date:  2010-06-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8004944     Medline TA:  Exp Lung Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  159-66     Citation Subset:  IM    
Affiliation:
Department of Surgical Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany. rolf.dembinski@post.rwth-aachen.de
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MeSH Terms
Descriptor/Qualifier:
Acute Lung Injury / drug therapy,  physiopathology,  therapy*
Administration, Inhalation
Animals
Anoxia / physiopathology,  therapy
Disease Models, Animal
Female
Hemodynamics / drug effects
Nitric Oxide / administration & dosage*
Positive-Pressure Respiration
Pulmonary Gas Exchange / drug effects
Respiration / drug effects*
Respiration, Artificial* / methods
Respiratory Mechanics / drug effects
Swine
Chemical
Reg. No./Substance:
10102-43-9/Nitric Oxide

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


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