Document Detail


Effects of nitric oxide synthase inhibition combined with nitric oxide inhalation in a porcine model of endotoxin shock.
MedLine Citation:
PMID:  7533615     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
1. The present investigation compares the effects of intravenous infusion of the NO synthase inhibitor NG-monomethyl-L-arginine (L-NMMA) with that of an inhalation with NO gas in a porcine model of endotoxin (lipopolysaccharide, LPS) shock. In addition, the effects of the combination of these two treatments were also investigated. 2. Male pigs were anaesthetized and instrumented for the measurement of haemodynamic parameters. Blood samples were withdrawn at different time intervals for determination of blood gases, pH, and plasma levels of nitrite/nitrate and tumour necrosis factor. 3. Endotoxin infusion (15 micrograms kg-1 h-1 for 3 h) caused a progressive fall in mean arterial blood pressure (MABP) and cardiac output (CO) and a biphasic increase in mean pulmonary arterial pressure (MPAP) and pulmonary vascular resistance (PVR). A continuous infusion of L-NMMA (0.1 mg kg-1 min-1) significantly attenuated the fall in MABP, but did not affect MPAP, CO and PVR. NO-inhalation (50 p.p.m.) did not affect MABP, but significantly blunted the biphasic increase in MPAP and PVR and significantly delayed the fall in CO. The combination of L-NMMA infusion (0.1 mg kg-1 min-1) with NO-inhalation (50 p.p.m.) completely prevented the fall in MABP, significantly improved CO, and attenuated the biphasic increase in MPAP and PVR. 4. Endotoxin also caused a decline in PaO2 and a rise of PaCO2. Infusion of L-NMMA neither affected the fall in PaO2 nor the increase in PaCO2. In contrast, inhalation with NO gas alone as well as the combined administration of L-NMMA infusion and NO-inhalation completely prevented the fall in Pao2 and significantly protected against the increase in Paco2.5. Infusion of endotoxin for 180 min resulted in a mortality of 58%, which was not affected by L-NMMA (63%). In contrast, treatment of LPS-animals with either NO-inhalation alone or NO inhalation plus L-NMMA completely prevented mortality.6. This investigation demonstrates that treatment with NO-inhalation, in order to prevent the dramatic increase in MPAP, PVR and the alterations in peripheral blood gases combined with systemic L-NMMAto improve systemic MABP and thus organ perfusion, may be a new therapeutic regimen in the treatment of septic shock.
Authors:
P Klemm; C Thiemermann; G Winklmaier; P A Martorana; R Henning
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of pharmacology     Volume:  114     ISSN:  0007-1188     ISO Abbreviation:  Br. J. Pharmacol.     Publication Date:  1995 Jan 
Date Detail:
Created Date:  1995-04-10     Completed Date:  1995-04-10     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7502536     Medline TA:  Br J Pharmacol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  363-8     Citation Subset:  IM    
Affiliation:
SBU Cardiovascular Agents, CASSELLA AG, Frankfurt am Main, Germany.
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Amino Acid Oxidoreductases / antagonists & inhibitors*
Animals
Arginine / analogs & derivatives,  pharmacology
Blood Gas Analysis
Escherichia coli
Hemodynamics / drug effects
Hydrogen-Ion Concentration
Leukocyte Count
Lipopolysaccharides
Male
Nitrates / blood
Nitric Oxide / antagonists & inhibitors,  pharmacology*
Nitric Oxide Synthase
Nitrites / blood
Platelet Count
Shock, Septic / physiopathology*
Swine
Tumor Necrosis Factor-alpha / metabolism
omega-N-Methylarginine
Chemical
Reg. No./Substance:
0/Lipopolysaccharides; 0/Nitrates; 0/Nitrites; 0/Tumor Necrosis Factor-alpha; 10102-43-9/Nitric Oxide; 17035-90-4/omega-N-Methylarginine; 74-79-3/Arginine; EC 1.14.13.39/Nitric Oxide Synthase; EC 1.4.-/Amino Acid Oxidoreductases
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