Organ dysfunction among piglets treated with inhaled nitric oxide and intravenous hydrocortisone during prolonged endotoxin infusion.

Abstract

OBJECTIVE:

It has previously been shown that a combination of inhaled nitric oxide (iNO) and intravenous (IV) steroid attenuates endotoxin-induced organ damage in a 6-hour porcine endotoxemia model. We aimed to further explore these effects in a 30-hour model with attention to clinically important variables.

DESIGN:

Randomized controlled trial.

SETTING:

University animal laboratory.

SUBJECTS:

Domestic piglets (n = 30).

INTERVENTIONS:

Animals were randomized into 5 groups (n = 6 each): 1) Controls, 2) LPS-only (endotoxin/lipopolysaccharide (LPS) infusion), 3) LPS + iNO, 4) LPS + IV steroid, 5) LPS + iNO + IV steroid.

MEASUREMENTS AND MAIN RESULTS:

Exposure to LPS temporarily increased pulmonary artery mean pressure and impeded renal function with elevated serum creatinine and acidosis compared to a control group over the 30-hour study period. Double treatment with both iNO and IV steroid tended to blunt the deterioration in renal function, although the only significant effect was on Base Excess (p = 0.045). None of the LPS + iNO + IV steroid treated animals died during the study period, whereas one animal died in each of the other LPS-infused groups.

CONCLUSIONS:

This study suggests that combined early therapy with iNO and IV steroid is associated with partial protection of kidney function after 30 hours of experimental LPS infusion.

• Authors: Sofie Paues Göranson, Waldemar Goździk, Piotr Harbut, Stanisław Ryniak, Stanisław Zielinski, Caroline Gillis Haegerstrand, Andrzej Kübler, Göran Hedenstierna, Claes Frostell, Johanna Albert
• Journal: PloS one (PLoS One) Vol. 9 Issue 5 Pg. e96594 ( 2014) ISSN: 1932-6203 [Electronic] United States
• PMID: 24827456 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Lipopolysaccharides
• Protective Agents
• Nitric Oxide
• Creatinine
• Hydrocortisone

Topics

• Administration, Inhalation
• Animals
• Creatinine (blood)
• Disease Models, Animal
• Endotoxemia (blood, chemically induced, physiopathology, prevention & control)
• Hemodynamics (drug effects)
• Hydrocortisone (pharmacology)
• Injections, Intravenous
• Kidney (drug effects, metabolism, physiopathology)
• Kidney Function Tests
• Lipopolysaccharides
• Nitric Oxide (pharmacology)
• Protective Agents (pharmacology)
• Swine
• Time Factors