Document Detail


Inhaled nitric oxide does not enhance lipid peroxidation in patients with acute respiratory distress syndrome.
MedLine Citation:
PMID:  11057797     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate whether inhaled nitric oxide (NO) enhances pulmonary lipid peroxidation as indicated by arterial blood levels of malondialdehyde, hexanal, and pentanal in patients with acute respiratory distress syndrome (ARDS). DESIGN: Prospective, nonrandomized, controlled trial. SETTING: Surgical intensive care unit in a university hospital. PATIENTS: Twenty-five patients with ARDS, as defined by the American-European Consensus Conference, and a PaO2/FIO2 < or = 170 mm Hg were enrolled in the study. Four healthy subjects were studied as controls. INTERVENTIONS: On enrollment of the patients in the study, a dose-response test with increasing concentrations of inhaled NO (0, 2, 10, 40, 0 ppm) was performed. Patients who showed an increase of >20% in PaO2 were designated as responders and all others as nonresponders. In responders, this dose-response test was followed by 24 hrs of continuous treatment with inhaled NO at the best NO concentration determined during the dose-response test, whereas nonresponders received standard care. For healthy volunteers, the dose-response test took the form of spontaneous breathing of the same NO concentrations. MEASUREMENTS AND MAIN RESULTS: Eighteen patients (72%) showed an increase of >20% in PaO2 during the dose-response test. This significant improvement in arterial oxygenation in responders led to a significant reduction in FIO2 (responders, 0.73 +/- 0.05 vs. nonresponders, 0.89 +/- 0.05) after 24 hrs of therapy. On enrollment, arterial blood concentrations of malondialdehyde, hexanal, and pentanal were significantly higher than those of healthy volunteers. In addition, arterial concentrations of hexanal and pentanal exceeded mixed venous levels two- to ten-fold. Inhalation of NO did not significantly alter these blood concentrations either during the dose response test or during 24 hrs of therapy. CONCLUSIONS: In patients with ARDS, malondialdehyde, hexanal, and pentanal were significantly elevated, indicating lipid peroxidation. Lipid peroxidation was not further affected by inhalation of NO.
Authors:
M A Weigand; S A Snyder-Ramos; A G Möllers; J Bauer; D Hansen; W Kochen; E Martin; J Motsch
Related Documents :
19034427 - Mechanical determinants of early acute ventilatory failure in copd patients: a physiolo...
15922687 - Recent advances in mechanical ventilation.
6481587 - A summary of preoperative and postoperative cardiorespiratory performance in patients u...
8404137 - Safety of thoracentesis in mechanically ventilated patients.
23579577 - Survivors versus nonsurvivors postburn: differences in inflammatory and hypermetabolic ...
6743777 - Klinefelter's syndrome and mitral valve prolapse. an echocardiographic study in twenty-...
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  28     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2000-11-15     Completed Date:  2000-11-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  3429-35     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Children's Hospital, University of Heidelberg, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Aged
Aldehydes / blood
Bronchodilator Agents / pharmacology,  therapeutic use*
Dose-Response Relationship, Drug
Drug Monitoring
Female
Free Radical Scavengers / pharmacology,  therapeutic use*
Humans
Lipid Peroxidation / drug effects*
Male
Malondialdehyde / blood
Middle Aged
Nitric Oxide / pharmacology,  therapeutic use*
Prospective Studies
Respiratory Distress Syndrome, Adult / diagnosis,  drug therapy*,  metabolism*,  mortality
Survival Analysis
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Aldehydes; 0/Bronchodilator Agents; 0/Free Radical Scavengers; 10102-43-9/Nitric Oxide; 110-62-3/pentanal; 542-78-9/Malondialdehyde; 66-25-1/n-hexanal

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


Previous Document:  Effect of mortality rate on the performance of the Acute Physiology and Chronic Health Evaluation II...
Next Document:  Cervical spine clearance and neck extension during percutaneous tracheostomy in trauma patients.