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Effect of inhaled nitric oxide on pulmonary hemodynamics after acute lung injury in dogs

Romand, JA and Pinsky, MR and Firestone, L and Zar, HA and Lancaster, JR (1994) Effect of inhaled nitric oxide on pulmonary hemodynamics after acute lung injury in dogs. Journal of Applied Physiology, 76 (3). 1356 - 1362. ISSN 8750-7587

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Increased pulmonary vascular resistance (PVR) and mismatch in ventilation- to-perfusion ratio characterize acute lung injury (ALI). Pulmonary arterial pressure (Ppa) decreases when nitric oxide (NO) is inhaled during hypoxic pulmonary vasoconstriction (HPV); thus NO inhalation may reduce PVR and improve gas exchange in ALI. We studied the hemodynamic and gas exchange effects of NO inhalation during HPV and then ALI in eight anesthetized open- chest mechanically ventilated dogs. Right atrial pressure, Ppa, and left ventricular and arterial pressures were measured, and cardiac output was estimated by an aortic flow probe. Shunt and dead space were also estimated. The effect of 5-min exposures to 0, 17, 28, 47, and 0 ppm inhaled NO was recorded during hyperoxia, hypoxia, and oleic acid-induced ALI. During ALI, partial β-adrenergic blockade (propranolol, 0.15 mg/kg iv) was induced and 74 ppm NO was inhaled. Nitrosylhemoglobin (NO-Hb) and methemoglobin (MetHb) levels were measured. During hyperoxia, NO inhalation had no measurable effects. Hypoxia increased Ppa (from 19.8 ± 6.1 to 28.3 ± 8.7 mmHg; P < 0.01) and calculated PVR (from 437 ± 139 to 720 ± 264 dyn · s · cm-5, P < 0.01), both of which decreased with 17 ppm NO. ALI decreased arterial PO2 and increased airway pressure, shunt, and dead space ventilation. Ppa (19.8 ± 6.1 vs. 23.4 ± 7.7 mmHg) and PVR (437 ± 139 vs. 695 ± 359 dyn · s · cm-5, P < 0.05) were greater during ALI than during hyperoxia. NO inhalation had no measurable effect during ALI before or after β-adrenergic blockade. MetHb remained low, and NO-Hb was unmeasurable. Bolus infusion of nitroglycerin (15 μg) induced an immediate decrease in Ppa and PVR during ALI. Short-term NO inhalation does not affect PVR or gas exchange in dogs with oleic acid-induced ALI, nor does it increase NO-Hb or MetHb. In contrast, NO can diminish hypoxia-induced elevations in pulmonary vascular tone. These data suggest that NO inhalation selectively dilates the pulmonary circulation and specifically reduces HPV but not oleic acid-induced increases in pulmonary vasomotor tone.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Romand, JA
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Firestone, L
Zar, HA
Lancaster, JR
Date: 1 January 1994
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Journal or Publication Title: Journal of Applied Physiology
Volume: 76
Number: 3
Page Range: 1356 - 1362
DOI or Unique Handle: 10.1152/jappl.1994.76.3.1356
Institution: University of Pittsburgh
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 8750-7587
Related URLs:
Date Deposited: 01 Mar 2012 20:18
Last Modified: 22 Jun 2021 14:55


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