Effects of inhaled nitric oxide on erythrocyte deformability in septic acute lung injury / 中国小儿急救医学

ABSTRACT

Objective To investigate the effects and related mechanism of iNO on erythrocyte deformability in septic acute lung injury(ALI).Methods Thirty anesthetized and mechanically ventilated young piglets(3-4weeks old)were allocated to 4 groups(1)normal(group C,n=6)intraperitoneal injection of normal saline(NS).(2)normal+iNO(group CNO,n=4)NS followed by mechanical ventilation for 4 h,and then treated with iNO at 10 parts per million in volume(ppm).(3)model(group M,n=10)i.p.Escherichia coli at 5 × 109 cfu/ml,5 ml,and(4)NO(group MNO,n=10)i.p.Eschefichia coli at 5×109 cfu/ml lollowed by iNO-at 10 parts per million after ALI.Blood viscosity,malondialdehyde(MDA)in erythrocyte,Ca2+-Mg2+-ATPase and Na+-K+-ATPase of erythrocyte membrane were measured at basdine,establishment of ALI,12 and 24 h during the treatment.Results For normal age-matched piglets,there was little change of whole blood viscosity at high shear rate(110 s-1),which is a measure of erythrocyte deformability,so was the level of MDA in erythroeyte and the activity of erythroeyte membrane Ca2+-Mg2+-ATPase,Na+-K+-ATPase when iNO was provided for 12 or 24 h.At the time ALI was established,whole blood viscosity at high shear rate and MDA levels in erythroeyte increased significantly compared to the baseline level(P＜0.05),while the activity of erythrocyte membrane Ca2+-Mg2+-ATPase and Na+-K+-ATPase decreased significantly(P＜0.01,vsbaseline).Exposure of iNO for 12 h resulted in decreased whole blood viscosity at high shear rate and MDA levels in erythroeyte(P＜0.05,vs group C),and higher activity of erythrocyte membrane Ca2+-Mg2+-AT-Pase and Na+-K+-ATPase.When iNO was administered for 24 h,there was little difference of whole blood viscosity,activity of erythrocyte membrane Ca2+-Mg2+-ATPase,Na+-K+-ATPase and MDA levels in erythroeyte between the C and NO groups.Conclusion In the piglets with septic ALI,there was deterioration of erythrocyte deformability.Inhaled NO for 12 h may alter the deterioration,however,this effect is transient.