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Service de Réanimation Médicale et Assistance Respiratoire, Lyon 69004; Equipe d'Accueil Universitaire 1896, Université Claude Bernard Lyon I, 69008 Lyon; Centre d'Exploration et de Recherche Médicales par Emission de Positons, Hôpital Neuro-Cardiologique, 69003 Lyon, France
In a porcine model of
oleic acid-induced lung injury, the effects of inhaled nitric oxide
(iNO) and intravenous almitrine bismesylate (ivALM), which enhances
the hypoxic pulmonary vasoconstriction on the distribution of regional
pulmonary blood flow (PBF), were assessed. After injection of 0.12 ml/kg oleic acid, 20 anesthetized and mechanically ventilated piglets
[weight of 25 ± 2.6 (SD) kg] were randomly divided into four
groups: supine position, prone position, and 10 ppm iNO for 40 min
followed by 4 µg · kg
1 · min
1
ivALM for 40 min in supine position and in prone position. PBF was
measured with positron emission tomography and
H215O. The redistribution of PBF was studied on
a pixel-by-pixel basis. Positron emission tomography scans were
performed before and then 120, 160, and 200 min after injury. With
prone position alone, although PBF remained prevalent in the dorsal
regions it was significantly redistributed toward the ventral
regions (P < 0.001). A ventral redistribution of PBF
was also obtained with iNO regardless of the position
(P = 0.043). Adjunction of ivALM had no further effect on PBF redistribution. PP and iNO have an additive effect on ventral redistribution of PBF.
prone position; oleic acid; pulmonary blood flow; positron emission tomography; inhaled nitric oxide
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