J Korean Pediatr Soc.  2003 Aug;46(8):777-783.

Effect of Inhaled Nitric Oxide on Hemodynamics, Gas Exchange and Pulmonary Inflammation in Newborn Piglets with Escherichia coli Induced Septic Lungs

• Chang YS
• Ko SY
• Park WS

Abstract

PURPOSE
The aim of this study was to evaluate the effect of inhaled nitric oxide(iNO) on gas exchange, hemodynamics and pulmonary inflammation in newborn piglets with E. coli induced septic lung.
METHODS
Twenty three instrumented and ventilated piglets were randomized into three groups: CON(n=6), PCON(n=9), and PNO(n=8). In the piglets of the PCON and PNO groups, E. coli septic lung was induced by endotracheal instillation of E. coli. Ten ppm iNO was given continuously in the PNO group after endotracheal instillation of E. coli. All animals were mechanically ventilated for six hour with a peak inspiratory pressure of 30 cmH2O, frequency of 25 breaths/min, FiO2 1.0 and a positive end-expiratory pressure of 4 cmH2O. All measurements were made at one hour intervals during the experiment. At the end of the experiment, lung tissue was harvested for the analysis of myeloperoxidase activity, indicative of lung inflammation.
RESULTS
All piglets with pulmonary instillation of E. coli developed E. coli sepsis. Piglets in the PCON group developed progresseve pulmonry hypertension, hypoxemia and hypercarbia compared to the CON group due to increased pulmonary vascular resistance, intrapulmonary shunt fraction and physiologic dead space fraction. iNO did not reverse pulmonary hypertension in the PNO group. However iNO significantly improved oxygenation, which was attributed to marked improvement of venous admixture and partial attenuation of increase in dead space fraction. Increased myeloperoxidase activity in PCON compared to CON was significantly attenuated in PNO.
CONCLUSION
iNO improves oxygenation and lung inflammation in newborn piglets with E. coli induced septic lung.

Keyword

Nitric oxide inhalation; Septic lung; Gas exchange; Hemodynamics; Piglet

MeSH Terms

Animals
Anoxia
Escherichia coli*
Escherichia*
Hemodynamics*
Humans
Hypertension
Hypertension, Pulmonary
Infant, Newborn*
Lung*
Nitric Oxide*
Oxygen
Peroxidase
Pneumonia*
Positive-Pressure Respiration
Sepsis
Vascular Resistance
Nitric Oxide
Oxygen
Peroxidase