Inhaled nitric oxide as a prophylactic treatment against reperfusion injury of the lung.

BACKGROUND

Inhaled Nitric Oxide (NO) has been found to be effective in clinical treatment of reperfusion injury after lung transplantation. This study was designed to determine a possible prophylactic role to reduce severe reperfusion injury.

METHODS

In 12 minipigs the left lung was selectively perfused with cold Euro-Collins solution. After 90 minutes of warm ischemia the lungs were reperfused and the contralateral pulmonary artery and main bronchus clamped. Hemodynamic and respiratory parameters were monitored for 7 hours. 6 animals were used as controls. 6 pigs formed the NO group and were ventilated continuously with 40 ppm nitric oxide (NO) starting 30 minutes prior to reperfusion.

RESULTS

In the control group right heart failure developed within 1.9 +/- 0.8 hours of reperfusion. Lung compliance was significantly reduced. A significant increase of pulmonary vascular resistance (PVR) was found. All animals of the NO group survived the reperfusion period of 7 hours. PVR was decreased compared to controls (p = 0.03). AaDO2 was lower, but not significantly different. The dynamic compliance of the lung was significantly higher (p = 0.007) in the NO group.

CONCLUSIONS

The prophylactic institution of inhaled NO reduces reperfusion injury of the lung. Short-term use of inhaled NO should be adopted as a prophylactic agent after transplantation of lungs preserved in Euro-Collins solution.