Chonnam Med J.  2002 Jun;38(2):113-120.

Cardiopulmonary Effects of Aerosolized Prostaglandin E1 During Inverse Ratio Ventilation in an Acute Lung Injury Model

• Kwak SH
• Kim JS
• Choi JI

Abstract

Inverse ratio ventilation using pressure controlled ventilation (PC-IRV) may be of therapeutic benefit in patients with acute respiratory distress syndrome (ARDS). The present study investigated the effects of aerosolized prostaglandin E1 (PGE1) during PC-IRV on lung function and pulmonary circulation in rabbits with ARDS. Twenty-eight adult albino rabbits weighing 2.5+/-.3 kg were acutely instrumented under intravenous anesthesia using ketamine (4 mg/kg/hr) and pancuronium (0.05 mg/kg/hr) to perform tra- cheostomy and to measure aortic, central venous and left atrial pressures, pulmonary and left anterior descending (LAD) blood flows with doppler flowmeter. Lung injury was induced by intravenous oleic acid 1 hour after they were divided into four groups of 7 animals. Group 1 received mechanical ventilation using pressure controlled mode (PCV) alone, group 2 received aerosolized PGE1 (5 microgramfollowed by 0.1 microgramkg/min) under PCV, group 3 received PC-IRV alone, and group 4 received aerosolized PGE1 (5 microgramfollowed by 0.1 microgramkg/min) under PC-IRV. Measurements were performed at 30-min intervals for 120 min after lung injury. After lung injury, hypoxemia, hypercapnea, acidosis, and pulmonary hypertension were developed in all animals and sustained in groups 1 and 2 throughout the experiment. The partial pressure of oxygen in arterial blood (PaO2) of animals in group 3 and 4 was significantly improved with initiation of treatment and sustained throughout the experiment as compared with controls. But, the improvement of PaO2 in group 4 was better than in group 3. Statistically significant reductions in mean pulmonary artery pressure were seen only in group 4 animals. These results suggest that aerosolized PGE1 (5 microgramfollowed by 0.1 microgramkg/min) during PC-IRV may be a useful therapeutic strategy for patients with ARDS.

Keyword

Acute lung injury; Inverse ratio ventilation; Oleic acid; Prostagrandin E1

MeSH Terms

Acidosis
Acute Lung Injury*
Adult
Alprostadil*
Anesthesia, Intravenous
Animals
Anoxia
Atrial Pressure
Flowmeters
Humans
Hypertension, Pulmonary
Ketamine
Lung
Lung Injury
Oleic Acid
Oxygen
Pancuronium
Partial Pressure
Pulmonary Artery
Pulmonary Circulation
Rabbits
Respiration, Artificial
Respiratory Distress Syndrome, Adult
Ventilation*
Alprostadil
Ketamine
Oleic Acid
Oxygen
Pancuronium