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Independent and Combined Effects of Inhaled Nitric Oxide, Liquid Perfluorochemical, and High-Frequency Oscillatory Ventilation in Premature Lambs With Respiratory Distress Syndrome*

John P. Kinsella, MD; Thomas A. Parker, MD; Henry Galan, MD; Brett C. Sheridan, MD; Steven H. Abman, MD
Author and Funding Information

*From the Pediatric Heart Lung Center, and the Departments of Pediatrics (Drs. Kinsella, Parker, and Abman), Obstetrics and Gynecology (Dr. Galan), and Surgery (Dr. Sheridan), University of Colorado School of Medicine, Denver, CO.

Correspondence to: John P. Kinsella, MD, Pediatric Heart Lung Center, Department of Pediatrics, Children’s Hospital, 1056 East 19th Ave, Denver, CO 80218



Chest. 1999;116(suppl_1):15S-16S. doi:10.1378/chest.116.suppl_1.15S
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Extract

Acute lung injury during conventional ventilation in the premature lamb with respiratory distress syndrome (RDS) is characterized by progressive deterioration in gas exchange and lung inflammation. Inhaled nitric oxide (iNO), high-frequency oscillatory ventilation (HFOV), and partial liquid ventilation (PLV) have been proposed as new therapies that may improve oxygenation while minimizing the severity of acute lung injury. The relative and combined effectiveness of these three therapies in improving gas exchange and decreasing inflammation in severe RDS is uncertain. We hypothesized that the two lung recruitment strategies (HFOV and PLV) would have similar effects on gas exchange and lung inflammation, and would augment the response to low-dose iNO. To test this hypothesis, we studied the individual and combined effects of iNO, HFOV, and PLV in 31 extremely premature lambs (115 days, 0.78 term; 147 days = term) using seven mechanical ventilation protocols.


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