Abstract 80

Objective: To investigate the individual and combined effects of PAGE and INO on oxygenation, pulmonary mechanics and hemodynamics in surfactant deficient piglets.

Methods: 18 ventilated piglets had surfactant-deficient acute lung injury induced with repeated saline lavage. Seventeen animals survived the lavage procedure and were allocated to: Group 1 (n=6) - conventional ventilation(CV) for 2 hours; Group 2 (n=6) - CV+INO (40ppm) for 1 hour then CV+INO+PAGE for 1 hour; Group 3 (n=5) - CV+PAGE for 1 hour then CV+PAGE+INO for 1 hour. PAGE was started by instilling 25 mls/kg of FC-77 over approximately 20 minutes, with regular top-ups. PaO2, oxygenation index (OI), pulmonary mechanics and hemodynamic variables were measured/calculated pre and post-lavage, and at 1 and 2 hours. Cardiac output was measured by thermodilution method and pulmonary vascular resistance calculated. Lung histology was scored for signs of acute injury.

Results: Oxygenation increased with both PAGE and INO compared with controls. There were no significant differences in lung mechanics, PVR or lung injury scores. Table

Table 1
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Conclusions: In this model improved oxygenation was seen with PAGE and INO combined. There was a trend toward greater improvement when PAGE was added to INO compared with adding INO to PAGE. These oxygenation changes were not accompanied by improvements in pulmonary mechanics, hemodynamics or lung injury scores.