Effectiveness of nitric oxide during spontaneous breathing in experimental lung injury

Dembinski, Rolf; Hochhausen, Nadine; Terbeck, Sandra; Bickenbach, Johannes; Stadermann, Frederik; Rossaint, Rolf; Kuhlen, Ralf (2010). Effectiveness of nitric oxide during spontaneous breathing in experimental lung injury. Experimental lung research, 36(3), pp. 159-66. New York, N.Y.: Informa Healthcare 10.3109/01902140903225416

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Inhaled nitric oxide (iNO) improves gas exchange in about 60% of patients with acute respiratory distress syndrome (ARDS). Recruitment of atelectatic lung areas may improve responsiveness and preservation of spontaneous breathing (SB) may cause recruitment. Accordingly, preservation of SB may improve effectiveness of iNO. To test this hypothesis, iNO was evaluated in experimental acute lung injury (ALI) during SB. In 24 pigs with ALI, effects of 10 ppm iNO were evaluated during controlled mechanical ventilation (CMV) and SB in random order. Preservation of SB was provided by 4 different modes: Unassisted SB was enabled by biphasic positive airway pressure (BIPAP), moderate inspiratory assist was provided by pressure support (PS) and volume-assured pressure support (VAPS), maximum assist was ensured by assist control (A/C). Statistical analysis did not reveal gas exchange improvements due to SB alone. Significant gas exchange improvements due to iNO were only achieved during unassisted SB with BIPAP (P <.05) but not during CMV or assisted SB. The authors conclude that effectiveness of iNO may be improved by unassisted SB during BIPAP but not by assisted SB. Thus combined iNO and unassisted SB is possibly most effective to improve gas exchange in severe hypoxemic ARDS.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Terbeck, Sandra

ISSN:

0190-2148

Publisher:

Informa Healthcare

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:09

Last Modified:

04 May 2014 23:05

Publisher DOI:

10.3109/01902140903225416

PubMed ID:

20337573

Web of Science ID:

000276945000004

URI:

https://boris.unibe.ch/id/eprint/1104 (FactScience: 201859)

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