In acute lung injury, inhaled nitric oxide improves ventilation-perfusion matching, pulmonary vascular mechanics, and transpulmonary vascular efficiency

Acute respiratory distress syndrome continues to be associated with significant morbidity and mortality related to ventilation-perfusion mismatch, pulmonary hypertension, and right ventricular failure. It has been suggested that inhaled nitric oxide, which is a selective pulmonary vasodilator, may b...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of thoracic and cardiovascular surgery 1995-09, Vol.110 (3), p.593-600
Main Authors: Hillman, Neal D., Meliones, Jon N., Black, Donald R., Craig, Damian M., Cheifetz, Ira M., Smith, Peter K.
Format: Article
Language:English
Subjects:
Administration, Inhalation
Analysis of Variance
Animals
Disease Models, Animal
Hemodynamics - drug effects
Nitric Oxide - administration & dosage
Nitric Oxide - therapeutic use
Oxygen - blood
Pulmonary Circulation - drug effects
Pulmonary Gas Exchange - drug effects
Pulmonary Wedge Pressure - drug effects
Respiratory Distress Syndrome, Adult - drug therapy
Respiratory Distress Syndrome, Adult - physiopathology
Swine
Vascular Resistance - drug effects
Ventilation-Perfusion Ratio - drug effects
Ventricular Function, Right - drug effects
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Acute respiratory distress syndrome continues to be associated with significant morbidity and mortality related to ventilation-perfusion mismatch, pulmonary hypertension, and right ventricular failure. It has been suggested that inhaled nitric oxide, which is a selective pulmonary vasodilator, may be effective in the treatment of acute respiratory distress syndrome; however, the effects of nitric oxide on cardiopulmonary interactions are poorly understood. We therefore developed a model of acute lung injury that mimics the clinical syndrome of acute respiratory distress syndrome. In our model, inhaled nitric oxide significantly reduced pulmonary artery pressure, pulmonary vascular resistance, and pulmonary vascular impedance. In addition, inhaled nitric oxide improved transpulmonary vascular efficiency and ventilation-perfusion matching, which resulted in increased arterial oxygen tension. Although arterial oxygen tension increased, oxygen delivery did not improve significantly. These data suggest that by improving ventilation-perfusion matching and arterial oxygen tension while lowering pulmonary vascular resistance and impedance, nitric oxide may be beneficial in patients with acute respiratory distress syndrome. However, additional measures to enhance cardiac performance may be required. ( J T HORAC C ARDIOVASC S URG 1995;110: 593-600)
ISSN:0022-5223
1097-685X
DOI:10.1016/S0022-5223(95)70089-7