In:
BMC Anesthesiology, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2012-12)
Kurzfassung:
Mechanical ventilation with high tidal volumes may cause ventilator-induced lung injury (VILI) and enhanced generation of nitric oxide (NO). We demonstrated in sheep that pneumonectomy followed by injurious ventilation promotes pulmonary edema. We wished both to test the hypothesis that neuronal NOS (nNOS), which is distributed in airway epithelial and neuronal tissues, could be involved in the pathogenesis of VILI and we also aimed at investigating the influence of an inhibitor of nNOS on the course of VILI after pneumonectomy. Methods Anesthetized sheep underwent right pneumonectomy, mechanical ventilation with tidal volumes (V T ) of 6 mL/kg and FiO 2 0.5, and were subsequently randomized to a protectively ventilated group (PROTV; n = 8) keeping V T and FiO 2 unchanged, respiratory rate (RR) 25 inflations/min and PEEP 4 cm H 2 O for the following 8 hrs; an injuriously ventilated group with V T of 12 mL/kg, zero end-expiratory pressure, and FiO 2 and RR unchanged (INJV; n = 8) and a group, which additionally received the inhibitor of nNOS, 7-nitroindazole (NI) 1.0 mg/kg/h intravenously from 2 hours after the commencement of injurious ventilation (INJV + NI; n = 8). We assessed respiratory, hemodynamic and volumetric variables, including both the extravascular lung water index (EVLWI) and the pulmonary vascular permeability index (PVPI). We measured plasma nitrite/nitrate (NOx) levels and examined lung biopsies for lung injury score (LIS). Results Both the injuriously ventilated groups demonstrated a 2–3-fold rise in EVLWI and PVPI, with no significant effects of NI. In the INJV group, gas exchange deteriorated in parallel with emerging respiratory acidosis, but administration of NI antagonized the derangement of oxygenation and the respiratory acidosis significantly. NOx displayed no significant changes and NI exerted no significant effect on LIS in the INJV group. Conclusion Inhibition of nNOS improved gas exchange, but did not reduce lung water extravasation following injurious ventilation after pneumonectomy in sheep.
Materialart:
Online-Ressource
ISSN:
1471-2253
DOI:
10.1186/1471-2253-12-10
Sprache:
Englisch
Verlag:
Springer Science and Business Media LLC
Publikationsdatum:
2012
ZDB Id:
2091252-3
