Journal article

Publication year: 1999

Pages: 1179-1187

Journal: American Journal of Respiratory and Critical Care Medicine

Volume number: 160

Issue number: 4

ISSN: 1073-449X

DOI Link: https://doi.org/10.1164/ajrccm.160.4.9808034

Publisher: American Thoracic Society

Abstract: 
Lung ischemia-reperfusion provokes pulmonary hypertension and increased microvascular permeability with subsequent edema formation and hypoxemia. We exposed buffer-perfused rabbit lungs to 120 and 180 min of warm ischemia. After reperfusion, gas exchange disturbances were analyzed by the multiple inert gas elimination technique (MIGET). Additionally, ischemic lungs were treated with different doses of inhaled nitric oxide (NO) throughout reperfusion. Reperfusion provoked a transient pulmonary artery pressure elevation, followed by progressive pulmonary edema formation. After 120 min of ischemia, severe ventilation-perfusion ((V) over dot A/(Q) over dot) mismatch developed within 15 min of reperfusion, with the appearance of low (V) over dot A/(Q) over dot areas and marked broadening of both perfusion and ventilation distribution in the midrange (V) over dot A/(Q) over dot regions. In parallel, shunt flow increased from less than 2% to approximately 17%. Inhalation of NO suppressed the presser response, edema formation, as well as (V) over dot A/(Q) over dot mismatch and shunt flow. Concentrations of 10 and 50 ppm NO were equipotent, surpassing the efficacy of 1 or 250 ppm NO. Inhalation of NO, however, did not protect from the overwhelming gas exchange and fluid balance disturbances provoked by 180 min ischemia. In conclusion, severe abnormalities in gas exchange occurred rapidly upon reperfusion of ischemic lungs. Prophylactic NO inhalation may be considered for maintenance of gas exchange in settings of ischemia-reperfusion including lung transplantation.

Harvard Citation style: Hermle, G., Schütte, H., Walmrath, D., Geiger, K., Seeger, W. and Grimminger, F. (1999) Ventilation-perfusion mismatch after lung ischemia-reperfusion -: Protective effect of nitric oxide, American Journal of Respiratory and Critical Care Medicine, 160(4), pp. 1179-1187. https://doi.org/10.1164/ajrccm.160.4.9808034

APA Citation style: Hermle, G., Schütte, H., Walmrath, D., Geiger, K., Seeger, W., & Grimminger, F. (1999). Ventilation-perfusion mismatch after lung ischemia-reperfusion -: Protective effect of nitric oxide. American Journal of Respiratory and Critical Care Medicine. 160(4), 1179-1187. https://doi.org/10.1164/ajrccm.160.4.9808034