The Science Journal of the American Association for Respiratory Care

1996 OPEN FORUM Abstracts

INHALED NITRIC OXIDE DOES NOT ADVERSELY AFFECT LUNG MECHANICS IN EXPERIMENTAL RESPIRATORY DISTRESS SYNDROME

Randy Scott David S. Garton, Leo M. Langga, Ricardo L. Peverini, Douglas D. Deming, Andrew O. Hopper. Loma Linda University Children's Hospital, Department of Respiratory Care, Loma Linda, CA.

INTRODUCTION: We previously reported a brief (30 minutes) administration of inhaled nitric oxide (INO) to premature lambs resulted in a worsening tidal volume and dynamic compliance. To determine if this effect is sustained, we measured lung mechanics in premature lambs randomized to receive either INO or not (Control) for four hours. Methods: We studied eight sets of premature lamb twins (119 - 126 days gestation, o0.8 term). Arterial and venous catheters, and tracheal tubes were placed and a modified natural surfactant (beractant) given prior to mechanical ventilation. Lambs were delivered, stabilized and mechanically ventilated for approximately two hours prior to baseline lung mechanic measurements. One twin was randomly assigned to receive 20 ppm INO while the other did not for the next four hours. Lung mechanic measurements - inspiratory tidal volume (V_{r}), dynamic compliance (C_{DYN}), respiratory system compliance (C_{RS}), and respiratory system resistance (R_{RS}) - were made hourly (Sensor Medics 2600). One lamb died before entry into the study. Results: There were no significant differences in the lung mechanic measurements between the INO and Control groups. Data in the table are mean ± SE at baseline and four hours. Data was analyzed by t-test for independent samples.

V\pi C_{DYN}

(mL/kg) mL/cm H_{2}O/kg)

Baseline 4h Baseline 4h

INO 13.6±2.7 11.1± 1.9 0.6± 0.1 0.6±0.1

n 8 7 8 7

Control 14.3± 2.1 11.7± 2.5 0.6± 0.04 0.6± 0.1

n 7 6 6 6

C_{RS} R_{RS}

(mL/cm H_{2}O/kg) (cm H_{2}O/mL/sec)

Baseline 4h Baseline 4h

INO 1.1± 0.2 0.9± 0.2 127±21 129± 21

n 8 7 8 7

Control 0.9± 0.2 0.6± 0.1 120± 8 118± 3

n 7 5 7 5

CONCLUSION: We conclude that a four hour administration of INO does not adversely affect lung mechanics in preterm lambs with experimental respiratory distress syndrome. We speculate that INO may be used in premature infants without compromising lung mechanics.

Reference: OF-96-156

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