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Article |

Inhaled Nitric Oxide Prevents Experimental Platelet Activating Factor—Induced Shock

Sherif Emil, MD, CM; Joel Berkeland, RRT; Mahmoud Kosi, MD; James Atkinson, MD
Arch Surg. 1996;131(8):855-860. doi:10.1001/archsurg.1996.01430200065012.
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Objective:  To investigate whether inhaled nitric oxide (INO) can prevent platelet activating factor (PAF)—induced pulmonary hypertension and shock.

Design:  Randomized controlled animal trial.

Setting:  Laboratory.

Subjects:  Yorkshire swine.

Interventions:  Animals received general anesthesia and invasive hemodynamic monitoring, then PAF only, 2.5 μg/kg intravenously over 45 minutes (PAF group, n=9) or PAF in addition to INO, 20 ppm (PAF-INO group, n=6).

Main Outcomes:  Vascular pressures (mean arterial and mean pulmonary), vascular resistance indexes (systemic and pulmonary), cardiac indexes, and oxygen delivery and oxygen consumption.

Results:  Mean arterial pressures, cardiac indexes, and oxygen delivery and consumption were significantly higher in the PAF-INO group. Mean pulmonary arterial pressures and systemic and pulmonary vascular resistance indexes were significantly lower in the PAF-INO group. There were 4 deaths (44%) in the PAF group vs none (0%) in the PAF-INO group (P=.10).

Conclusion:  The use of INO prevents pulmonary hypertension, circulatory failure, and death during PAF-induced shock.Arch Surg. 1996;131:855-860


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