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The Combination of Partial Liquid Ventilation and Inhaled Nitric Oxide in the Severe Oleic Acid Lung Injury Model FREE TO VIEW

Tokujiro Uchida; Koichi Nakazawa; Kuninori Yokoyama; Koshi Makita; Keisuke Amaha
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From the Department of Anesthesiology and Critical Care Medicine, Tokyo Medical and Dental University, School of Medicine, Tokyo, Japan

1998 by the American College of Chest Physicians

Chest. 1998;113(6):1658-1666. doi:10.1378/chest.113.6.1658
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Study objectives: To elucidate the efficacy of the combination of inhaled nitric oxide (NO) and partial liquid ventilation (PLV) in ARDS.

Design: Prospective, randomized, controlled study.

Setting: A research laboratory at a university medical center.

Subjects: Thirty-two rabbits.

Interventions: Animals were anesthetized and ventilated via tracheostomy (tidal volume=40 mL; respiratory rate=25 breaths/min; fraction of inspired oxygen=0.99). After 0.08 mL/kg (0.071 g/kg) oleic acid was administered via the central venous route, animals were randomly divided into the following four groups depending on the ventilatory mode: (1) Gas ventilation (GV)-control group: GV was continued throughout the study; (2) GV-NO group: NO inhalation (10 ppm) was performed under GV; (3) PLV-control group: PLV using perflubron (15 mL/kg) was continued until the end of the study; and (4) PLV-NO group: NO inhalation (10 ppm) was performed under PLV.

Measurements and results: NO inhalation improved PaO2 in the PLV-NO group (from 133±20 to 167±23 mm Hg; p=0.0008), but not in the GV-NO group (from 67±6 to 63±9 mm Hg), although pulmonary vascular resistance decreased both in the GV-NO (from 4,604±328 to 4,337±322 dyne·s·cm−5; p=0.0116) and the PLV-NO group (from 4,727±665 to 4,112±560 dyne·s·cm−5; p=0.0036). (Data were expressed as mean±SEM.)

Conclusion: PLV augmented the effect of inhaled NO on pulmonary gas exchange. The combination of PLV and NO inhalation could be effective in severe ARDS.




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