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Experimental and clinical studies on inhalaed nitric oxide therapy in pediatric surgery

吸入一氧化氮治疗小儿外科的实验与临床研究

基本信息

批准号：
06671792
负责人：
OBARA Hidefumi
金额：
$ 1.34万
依托单位：
KOBE UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1994
资助国家：
日本
起止时间：
1994 至 1995
项目状态：
已结题

项目摘要

Nitric oxide (NO) has been successfully used for treatment of pulmonary hypertension. The aim of our studies was to investigate the effect of NO inhalation therapy on acute lung injury associated with pulmonary hypertension.[1 : Experimental Study]The animals received one of four treatment : intravenous endotoxin, intravenous trypsin, intratracheal HCl, and ventilation with 100% oxygen. (1) Pulmonary hypertension induced by endotoxin or trypsin was attenuated by NO (5-20 ppm) inhalation. NO at these doses had no effect on systemic blood pressure. (2) Inhaled NO attenuated morphological changes in any model. (3) The number of neutrophils in bronchoalveolar lavage fluid was lower in NO inhalation group than in NO non-treated group suggesting that NO inhibited aggregation and adhesion of the cells. (4) Methemoglobin levels did not exceed 1.5% in any rabbit.[2 : Clinical Study]NO inhalation system for neonates and children was prepared. Nine patients with persistent pulmonary hypertension of neonates (PPHN) received NO inhalation (20 ppm for 4 hr and 6 ppm for 20 hr) . In 8 of 9 neonates, NO improved oxygenation index by 20% : the efficacy was 89%. In some cases, NO inhalation facilitated weaning from ECMO.In conclusion, these results of the experimental and clinical studies suggest that NO inhalation therapy is useful for acute lung injury and pulmonary hypertension.

一氧化氮（NO）已成功用于治疗肺动脉高压。我们研究的目的是调查一氧化氮吸入疗法对肺动脉高压相关急性肺损伤的影响。[1：实验研究]动物接受四种治疗方法之一：静脉注射内毒素、静脉注射胰蛋白酶、气管内注射HCl和100%氧气通气。 (1) 吸入NO (5-20 ppm)可减轻由内毒素或胰蛋白酶引起的肺动脉高压。这些剂量的 NO 对全身血压没有影响。 (2) 吸入NO可减弱任何模型中的形态变化。 (3)NO吸入组支气管肺泡灌洗液中中性粒细胞数量低于NO未处理组，提示NO抑制细胞聚集和粘附。 (4)任何兔子的高铁血红蛋白水平均不超过1.5%。[2：临床研究]制备了新生儿和儿童用NO吸入系统。 9 名新生儿持续性肺动脉高压 (PPHN) 患者接受 NO 吸入（20 ppm，4 小时，6 ppm，20 小时）。 9 名新生儿中有 8 名，NO 使氧合指数提高了 20%：功效为 89%。在某些情况下，NO 吸入有助于脱离 ECMO。总之，这些实验和临床研究结果表明，NO 吸入疗法对于急性肺损伤和肺动脉高压是有用的。