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Canadian Journal of Anesthesia 51:A84 (2004)
© Canadian Anesthesiologists' Society, 2004

Abstracts - Tuesday June 22nd 2004 1030-1230

THE EFFECT OF PREVENTIVE INHALED NITRIC OXIDE ON PULMONARY REPERFUSION INJURY IN PIGS

Gilbert Blaise, MD, Lan Gao, PhD MD and Marius D. Gangal, PhD MD

Laboratoire d’anesthesie, Hospital Notre Dame du CHUM, 1560 rue Sherbrooke East, Montreal QC, H2L 4M1

INTRODUCTION

The beneficial effect of inhaled nitric oxide (INO) on pulmonary hypertension is well known but its anti-inflammatory effect is not well established. Cardiopulmonary bypass (CPB) is associated with a systemic and local (pulmonary) inflammatory response induced as a reperfussion injury. We evaluated the effect of different strategies of preventive INO administration on the pulmonary inflammatory reperfusion injury induced by CPB.

METHODS

We used an animal model developped in our laboratory (pigs) to observe the weaning strategies associated with the 24 h continous INO administration.

The animals were randomly divided into 4 groups.


Group Operation Ventilation Hemodynamics Specimen
Sham Sham 24h + 3 BAL (bronchoalveolar lavage)
CPB without INO CPB 24 h + 3 BAL
CPB with INO CPB+INO (preventive) 24 h + 3 BAL
CPB with INO gradually weaned CPB+ WINO (preventive) 24h + 3 BAL

RESULTS

Preventive INO reduce the local inflammatory reaction associated with the reperfusion injuries induced by CPB, influencing the cell population observed in BAL. The progressive weaning of INO after CPB is not followed by rebound of the inflammation.

DISCUSSION

We evaluated the effect of preventive INO on pulmonary hemodynamics, function and inflammation. Preventive INO is able to modulate the inflammatory response. Its short action impose further association of INO with various drugs that are able to further influence the pulmonary inflamation. We consider INO as a pivotal drug with an important role in the future.





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