HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Sophie Jaillard Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Jaillard, S. Articles by Storme, L. Search for Related Content PubMed PubMed Citation Articles by Jaillard, S. Articles by Storme, L.

Eur J Cardiothorac Surg 2000;18:334-341
© 2000 Elsevier Science NL

Effects of inhaled nitric oxide on gas exchange and acute lung injury in premature lambs with moderate hyaline membrane disease

^a Department of Thoracic Surgery, Centre Hospitalier Régional et Universitaire, 59037 Lille Cédex, France
^b Department of Physiology, Centre Hospitalier Régional et Universitaire, 59037 Lille Cédex, France
^c Department of Neonatology, Hôpital Jeanne de Flandre, Centre Hospitalier Régional et Universitaire, 59037 Lille Cédex, France
^d Department of Biophysics, Centre Hospitalier Régional et Universitaire, 59037 Lille Cédex, France
^e Department of Obstetrics, Centre Hospitalier Régional et Universitaire, 59037 Lille Cédex, France

Received 22 December 1999; received in revised form 11 April 2000; accepted 18 April 2000.

Corresponding author. Tel.: +33-3-2044-6467; fax: +33-3-2044-6236
e-mail: lstorme{at}chru-lille.fr

Objective: The purpose of this study was to examine whether inhaled nitric oxide (iNO) may change lung injury in moderate hyaline membrane disease (HMD). Methods: Fifteen moderately premature lambs (128 days gestation, term=147 days) were randomly assigned to treatment with 20 ppm inhaled NO (n=7) from the onset of ventilation or control (n=8). Except for inhaled NO, treatments were intentionally similar to those applied in clinical situations. After porcine surfactant administration (Curosurf, 100 mg/kg), mechanical ventilator settings were modified during the course of the study to maintain PaCO₂ between 40 and 50 mmHg and post-ductal SpO₂ between 90 and 95%. The main studied parameters were gas exchanges parameters, respiratory mechanics (static compliance and functional residual capacity) and pulmonary vascular permeability and/or filtration rate indices. Results: We found that 20 ppm of inhaled NO for 5 h significantly reduce ventilatory and oxygen requirements, but only during the first hour of mechanical ventilation. No increase in extravascular lung water content (5.41±0.96 vs. 5.46±1.09 ml/g bloodless dry lung in the control group and in the NO group, respectively) and no impairment of the respiratory mechanics could be found in the NO-treated group. However, inhaled NO increased the albumin lung leak index in this model (6.09±1.51 in the NO-treated group vs. 4.08±1.93 in the control group; P<0.05). Conclusions: Our results do not therefore support a detrimental effect of short-term exposure to low doses of NO inhalation in moderate HMD. However, it may induce an increase in lung vascular protein leakage. The pathophysiological consequences of this finding remain to be elucidated.

Key Words: Pulmonary vascular permeability • Respiratory distress syndrome • Lung leak index • Extravascular lung water content