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August 1996

Inhaled Nitric Oxide Prevents Experimental Platelet Activating Factor—Induced Shock

Author Affiliations

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

Arch Surg. 1996;131(8):855-860. doi:10.1001/archsurg.1996.01430200065012

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