The Combination of Partial Liquid Ventilation and Inhaled Nitric Oxide in the Severe Oleic Acid Lung Injury Model

Abstract

To elucidate the efficacy of the combination of inhaled nitric oxide (NO) and partial liquid ventilation (PLV) in ARDS. Prospective, randomized, controlled study. A research laboratory at a university medical center. Thirty-two rabbits. Animals were anesthetized and ventilated via tracheostomy (tidal volume=40 mL; respiratory rate=25 breaths/min; fraction of inspired oxygen=0.99). After 0.08 mL/kg (0.071 g/kg) oleic acid was administered via the central venous route, animals were randomly divided into the following four groups depending on the ventilatory mode: (1) Gas ventilation (GV)-control group: GV was continued throughout the study; (2) GV-NO group: NO inhalation (10 ppm) was performed under GV; (3) PLV-control group: PLV using perflubron (15 mL/kg) was continued until the end of the study; and (4) PLV-NO group: NO inhalation (10 ppm) was performed under PLV. NO inhalation improved PaO2 in the PLV-NO group (from 133+/-20 to 167+/-23 mm Hg; p=0.0008), but not in the GV-NO group (from 67+/-6 to 63+/-9 mm Hg), although pulmonary vascular resistance decreased both in the GV-NO (from 4,604+/-328 to 4,337+/-322 dyne x s x cm(-5); p=0.0116) and the PLV-NO group (from 4,727+/-665 to 4,112+/-560 dyne x s x cm(-5); p=0.0036). (Data were expressed as mean+/-SEM.) PLV augmented the effect of inhaled NO on pulmonary gas exchange. The combination of PLV and NO inhalation could be effective in severe ARDS.