Effect of the combination of positive end expiratory pressure and nitric oxide inhalation on oleic acid-induced acute lung injury in canine

AIM:To observe the effects of the combination of positive end expiratory pressure (PEEP) and 80×10^-6 nitric oxide (NO) inhalation on oleic acid induced acute lung injury (ALI) in canine.METHEDS:30 dogs were divided into 6 groups. Oleic acid was injected through Swan-Ganz catheter to induced ALI. Pulmonary and systemic hemodynamics,blood gas were measured in dogs before and after injection of oleic acid and the period of inhaled NO for 1-6 h. The methemoglobin(MHb) concentrations were measured. Histology and ultrastructure of the lung tissue were observed. RESULTS:(1) The combination of PEEP and 80×10^-6 NO inhalation rapidly reduced mean pulmonary arterial pressure (MPAP) and pulmonary vascular resistance (PVR), increased PaO₂/FiO₂, reduced A-aDO₂ without inducing significant change on systemic hemodynamics. Arterial blood levels of MHb did not change significantly. (2)The combination group was showed the lightest ALI change by HE stain and electron microscopy. CONCLUSION:The combination of PEEP and inhalation of 80×10^-6 NO significantly and rapidly increased PaO₂/FiO₂ without producing lung injury induced by high FiO₂ and high PEEP.