par Leeman, Marc ;Zegers De Beyl, Valérie ;Gilbert, Eric;Melot, Christian ;Naeije, Robert
Référence Journal of applied physiology, 74, 2, page (650-654)
Publication Publié, 1993
Article révisé par les pairs
Résumé : Inhibitors of endothelium-derived nitric oxide synthesis or activity have been reported to enhance hypoxic vasoconstriction in isolated lung preparations. We hypothesized that methylene blue, a guanylate cyclase inhibitor, and N(ω)-nitro-L-arginine, a nitric oxide synthase inhibitor, would increase pulmonary vascular tone and improve gas exchange in anesthetized and ventilated (inspired O2 fraction 0.4) dogs with oleic acid (OA) lung injury. Mean pulmonary arterial pressure-(Ppa) flow (Q̇) relationships (generated by a manipulation of venous return, which was increased by opening a femoral arteriovenous bypass or decreased by inflating an inferior vena cava balloon) and gas exchange (evaluated by arterial blood gases and SF6 intrapulmonary shunt determinations) were investigated before and after OA (0.06 ml/kg iv) and again after solvent (n = 8), methylene blue (8 mg/kg iv, n = 10), or N(ω)-nitro-L-arginine (40 mg/kg iv, n = 8) in a randomized order. OA administration induced pulmonary hypertension, decreased arterial PO2, and increased intrapulmonary shunt. After OA, solvent had no effect on pulmonary hemodynamics and gas exchange. Both methylene blue and N(ω)-nitro-L-arginine further increased Ppa at all levels of Q̇. Only methylene blue, however, improved gas exchange after OA (arterial PO2 from 71 ± 6 to 89 ± 12 Torr and intrapulmonary shunt from 44 ± 6 to 34 ± 6%, both P < 0.02). These results suggest that nitric oxide is released during OA lung injury and modulates pulmonary hypertension. Whether nitric oxide impairs the regulation of gas exchange in OA lung injury remains uncertain, however.