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EFFECT OF INHALED NITRIC OXIDE (INO) ON SURFACTANT IN PIGS

^* Department of anaesthesia, Hospital Notre-Dame, 1560, Sherbrooke street east, Montreal, Quebec H2L 4M1,
^** Departments of Physiology and Medicine, Lawson Health Research Institute, University of Western Ontario, London, Ontario, Canada N6A 4V2,
⁺ Department of anesthesia and reanimation, Centre Hospitalier Universitaire de liège, Domaine Universitaire du Sart Tilman, 4000 Liège, Belgium

INTRODUCTION

Nitric Oxide (NO) is known to possess both inflammatory¹ and anti-inflammatory² role in the lung and may influence other pulmonary functions. This study was designed to test whether inhale NO (iNO) affects the pulmonary surfactant content.

METHODOLOGY

To test this hypothesis, 30 pigs, weighing 30 to 40 kg, were randomized in two groups: one control group ( without NO inhalation) and one group exposed to 20 ppm NO for two hours. Haemodynamics and respiratory compliance were measured. For the measurement of the surfactant content, broncho-alveaolar lavage (BAL) was undertaken by fibroscopy 2 hours after the beginning of anaesthesia. Saline (60ml) was injected promptly and then withdrawn slowly to obtain optimal BAL specimens. The lavage was performed in the right accessory lobe and the specimens were then centrifuged at 1500 rpm for 8 min for removal of the cellular material. The supernatant was then transferred into ultra centrifuging tubes and then centrifuged 15 minutes at 40 000g to separate the small aggregate fraction from the large aggregate fraction. This study was performed with the approval of the institutional animal care committee in compliance with the guidelines of the Canadian Council on Animal Care. Extraction of the large aggregate and small aggregate was done using the Bligh and Dyer's method³.

RESULTS

The lung compliance of the pigs submitted to NO (n=15) was not significantly different from the compliance of the control group (27, 00 ± 4,58) ml/cmH₂O and (27,87 ± 5,34) ml/cmH₂O respectively. The airway pressure is similar for the two groups, 20,67 ± 3,22 cmH₂O for the control group and 20,73 ± 3,01 cmH₂O for the iNO exposed group. The content of large aggregate and the total calculation of surfactant, in the group with iNO, showed an increase of 36% (p=0.011)and 46%(p=0.012) respectively compare to the control group. The small aggregate didn't change significantly.

CONCLUSION

NO has regulatory effects on surfactant product, it is therefore possible that inhaled NO will replace the endogenous NO produced by upper airways bypassed by intubation.

REFERENCES

1 Am J Respir Cell Mol Biol 1999; 21:311–316[Abstract/Free Full Text]

2 Ann Thorac Surg 1998; 65:935–938[Abstract/Free Full Text]

3 Can J Biochem Physiol 1959; 37:911–917

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