Journal of Applied Physiology
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J Appl Physiol (August 30, 2002). doi:10.1152/japplphysiol.00313.2002
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Articles in PresS, published online ahead of print August 30, 2002
J Appl Physiol, 10.1152/jap.00313.2002
Submitted on April 10, 2002
Accepted on August 13, 2002

EFFECT OF POSITION, NITRIC OXIDE AND ALMITRINE ON LUNG PERFUSION IN A PORCINE MODEL OF ACUTE LUNG INJURY

JEAN CHRISTOPHE RICHARD1, MARC JANIER2, FRANCK LAVENNE2, VERONIQUE BERTHIER2, DIDIER LEBARS2, GUY ANNAT3, FRANCOIS DECAILLIOT3, and CLAUDE GUERIN1*

1 Service de Reanimation Medicale et Assistance Respiratoire, Hopital de la Croix-rousse, LYON, France; Equipe d'accueil 1896, Universite Claude Bernard LYON I, LYON, France
2 Centre d'Exploration et de Recherche Medicales par Emission de Positons, Hopital Neuro-Cardiologique, LYON, France
3 Equipe d'accueil 1896, Universite Claude Bernard LYON I, LYON, France

* To whom correspondence should be addressed. E-mail: claude.guerin{at}chu-lyon.fr.

In a porcine model of oleic acid (OA)-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 in a porcine model of oleic acid (OA)-induced lung injury. After injection of 0.12 ml/kg OA, 20 anesthetized and mechanically ventilated piglets (mean ± SD weight 25 ± 2.6 kg) were randomly divided into four groups: supine position (SP), prone position (PP), 10 ppm iNO for 40 minutes followed by 4 µg.kg-1.min-1 ivALM for 40 minutes in supine position and in prone position. PBF was measured using positron emission tomography (PET) and H215O. The redistribution of PBF was studied on a pixel-by-pixel basis. PET scans were performed before then 120 (T120), 160 (T160) and 200 (T200) minutes after injury. With prone position alone, even though PBF remained prevalent in the dorsal regions, as previously reported, it was significantly redistributed towards the ventral regions with prone position (p<0.001). A ventral redistribution of PBF was also obtained with iNO regardless 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.




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