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Sherif Emil, MD, CM; Joel Berkeland, RRT; Mahmoud Kosi, MD; James Atkinson, MD

Arch Surg. 1996;131(8):855-860.

Abstract
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

Author Affiliations
From the Division of Pediatric Surgery, Childrens Hospital, Los Angeles, Calif.

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