Regulation of regional lung perfusion by nitric oxide.

Full Abstract

Improved oxygenation has previously been shown in patients with acute lung injury when ventilated in prone position. We hypothesized that this was due to higher regional production of nitric oxide in dorsocaudal lung regions. We measured nitric oxide synthase mRNA expression and nitric oxide production by citrulline assay in ventral and dorsal lung tissue from patients. In volunteers, regional lung perfusion in prone and supine postures was assessed by single photon emission computed tomography using (99m)Tc macroaggregated albumin before and after inhibition of nitric oxide synthase by N(G)-monomethyl-L-arginine infusion. Nitric oxide synthase mRNA expression and nitric oxide production were significantly higher in dorsal compared with ventral lung regions. In supine posture, lung perfusion was shifted to ventral parts during nitric oxide synthase inhibition, whereas in the prone posture lung perfusion remained unchanged. Our results suggest a role for endogenous nitric oxide in regulation of regional pulmonary perfusion.

Author information

Author/s: Rimeika, Danguole (D); Nyrén, Sven (S); Wiklund, N Peter (NP); Koskela, Lotta Renström (LR); Tørring, Anders (A); Gustafsson, Lars E (LE); Larsson, Stig A (SA); Jacobsson, Hans (H); Lindahl, Sten G E (SG); Wiklund, Claes U (CU);

Affiliation: Department of Anaesthesiology, Karolinska Hospital, S-171 76 Stockholm, Sweden. sten.lindahl(-atsign-)ks.se

Journal and publication information

Publication Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies

Journal: American journal of respiratory and critical care medicine (Am J Respir Crit Care Med), published in United States. (Language: eng)

Reference: 2004-Aug; vol 170 (issue 4) : pp 450-5

Dates: Created 2004/08/10; Completed 2004/09/23; Revised 2006/11/15;

PMID: 15130909, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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