The Lung Is The Major Site That Produces Nitric Oxide To Induce Acute Pulmonary Oedema In Endotoxin Shock

2001 ◽  
Vol 28 (4) ◽  
pp. 315-320 ◽  
Author(s):  
Ru Ping Lee ◽  
David Wang ◽  
Shang Jyh Kao ◽  
Hsing I Chen
1995 ◽  
Vol 4 (2) ◽  
pp. 117-123 ◽  
Author(s):  
T. Mózes ◽  
E. M. van Gelderen ◽  
E. J. Mylecharane ◽  
P. R. Saxena

Endotoxin shock was induced in 31 anaesthetized pigs by infusion of 5 μg/kg of Escbeicbia coli endotoxin (LPS) over 60 min into the superior mesenteric artery. Fifteen of these pigs died within 30 min of the start of LPS infusion whereas the remaining 16 survived the experimental period of 2 h. In a group of nine pigs indomethacin (2 mg/kg, i.v.)was inected 20–25 rain after the start of LPS infusion at which time mean arterial blood pressure (MABP) had decreased below 40 mmHg indicating imminent death. Indomethacin immediately reversed the hypotension. In another group of five pigs, NG-nitro L-arginine-methyl ester (L-NAME, 1 and 3 mg/kg)was iniected 10 and 5 min, respectively, before the expected death without any beneficial effect on the hypotension. Three rain after the last dose of L-NAME, indomethacin (2 mg/kg, i.v.) was iniected. In three animals the hypotension was reserved by indomethacin, although this beneficial effect was delayed in comparison with the LP-Streated group not receiving L-NAME. Four pigs were pretreated with L-NAME, 3 mg/kg, i.v., 10 min prior to LPS infusion. All pretreated animals tended to die within 30 min of the start of the LPS infusion. Five rain before the expected death (20–25 rain after the start of LPS infusion) indomethacin (2 mg/kg) was inected. In three of these animals indomethacin reversed hypotenston and prevented death. Interestingly, this rise in the MABP developed very slowly. These results suggest that the beneficial effect of indomethacin in endotoxin shock might be related partially to interference with nitric oxide, which is not the only factor determining blood pressure levels during endotoxic shock.


The Lancet ◽  
1907 ◽  
Vol 170 (4397) ◽  
pp. 1606-1607 ◽  
Author(s):  
Leonard Williams

The Lancet ◽  
1908 ◽  
Vol 171 (4401) ◽  
pp. 48
Author(s):  
Samuel West ◽  
Alexander Bryce

Thorax ◽  
2008 ◽  
Vol 63 (10) ◽  
pp. 933-934 ◽  
Author(s):  
B C Creagh-Brown ◽  
A G Nicholson ◽  
R Showkathali ◽  
J S R Gibbs ◽  
L S G E Howard

2021 ◽  
Author(s):  
Ian Howard ◽  
Nicholas Castle ◽  
Loua Al Shaikh ◽  
Robert Owen

Background Acute heart failure is a common presentation to Emergency Departments (ED) the world over. Amongst the most common presenting signs and symptoms is dyspnoea due to acute pulmonary oedema, a life threatening emergency that if left untreated or poorly managed. There is increasing evidence demonstrating improved outcomes following the use of vasodilators or non invasive ventilation for these patients in the emergency setting. Consequently, the potential exists that initiating these therapies in the prehospital setting will similarly improve outcomes. Methods A historical cohort study was conducted to assess the effect of a prehospital initiated treatment protocol of nitrates plus non invasive ventilation (NIV) versus regular therapy for severe cardiogenic APO on all-cause in-hospital mortality at 7 days, 30 days, and in total. Secondary outcomes included changes in EMS respiratory and haemodynamic parameters; admission status; length of stay; and emergency endotracheal intubation. Results The intervention led to an approximate 85% reduction in adjusted odds of mortality at 7 days compared to the regular therapy (AOR 0.15, 95% CI: 0.05 to 0.46, p = 0.001); approximate 80% reduction in odds of mortality at 30 days (AOR 0.19, 95% CI: 0.07 to 48, p < 0.0001); and Approximate 60% reduction in odds of total mortality (AOR 0.25, 95% CI: 0.12 to 0.56, p = 0.001). Conclusion The results of this analysis provide strong evidence of the potential synergistic benefits that can be achieved with the early implementation of a simple treatment protocol of prehospital administered nitrates and initiation of NIV for cardiogenic APO.


The Lancet ◽  
1907 ◽  
Vol 170 (4398) ◽  
pp. 1721-1722
Author(s):  
James Barr ◽  
R.D. Mothersole

1979 ◽  
Vol 17 (12) ◽  
pp. 47-48

Most patients with heart failure and oedema should be treated with thiazide diuretics, which are effective, cheap, safe and easy to use. However, in severe congestive cardiac failure and renal failure haemodynamic and perhaps hormonal disturbances cause salt and water retention which resists thiazide diuretics. Patients with acute pulmonary oedema need a rapid intense diuresis which a thiazide diuretic cannot provide. In these circumstances a drug is needed which can cause the excretion of a substantial fraction of filtered sodium.


2017 ◽  
Vol 47 (1) ◽  
pp. 57-59 ◽  
Author(s):  
M Bonello ◽  
R Pullicino ◽  
AJ Larner

2020 ◽  
Vol 61 (3) ◽  
pp. 226-228
Author(s):  
Stefanos Archontakis ◽  
Constantina Aggeli ◽  
Yannis Dimitroglou ◽  
Nikolas Koumallos ◽  
Michael Demosthenous ◽  
...  

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