Amelioration of pulmonary pathophysiology of adult respiratory distress syndrome by sulindac, a cyclo-oxygenase inhibitor.

The effects of sulindac, a cyclo-oxygenase inhibitor, were tested in a bacteremic porcine model of acute respiratory failure produced by a continuous infusion of live Pseudomonas aeruginosa. Control groups received either a single intravenous dose of sulindac (6 mg/kg) 20 minutes after baseline determinations or a continuous infusion of Ps. aeruginosa (10(7) CFU/kg/min) beginning at time 0. The experimental group received both. Sulindac alone had no effect on any hemodynamic or gas exchange parameter. Ps. aeruginosa infusion caused pulmonary hypertension, hypoxemia, increased intrapulmonary shunt fraction, systemic hypotension, and increased extravascular lung water. Sulindac treatment reversed the pulmonary hypertension, hypoxemia, and increased intrapulmonary shunting, prevented the systemic hypotension, but had no effect on the rising extravascular lung water.