Inalaçäo de oxido nitrico em SARA / Inhaled nitric oxide in ARDS

Os autores discutem sua experiência preliminar na administração de NO em nove pacientes adultos(30-75 anos)com SARA (LIS _> 3). A concentração de No foi ajustada a partir do efeito da inalação(de 1,5,10 ou 20 ppm)deste gás sobre a oxigenação arterial(Pa)2/FIO2). Observou-se em sete pacientes,melhora clinicamente significativa(_> 20 por cento do controle)da oxigenação. Em seis casos,a melhora permitiu interromper a administração de NO. Três mortes(choques hemorrágicos e séptico e broncopneumonia)foram registrados durante o tratamento,sem que fosse possível estabelecer relação causal entre a inalação de NO e o decesso.Discutem ainda diversos aspectos da utilização de NO na SARA. concluem que a inalação de NO representa alternativa simples,segura e eficaz no controle da hipoxemia grave,podendo com vantagem ser associada as alternativas(PEEO e posição prona)correntemente disponíveis em ventilação artificial

Effects of age on a new animal model of tardive dyskinesia.

The effects of age were studied on a new animal model of tardive dyskinesia, i.e., the quantification of oral dyskinesia in rats repeatedly treated with reserpine. Adult and old rats received two injections of reserpine (0.5 or 1.0 mg/kg s.c.) or vehicle, separated by 48 h. One, 10, 25 and 40 days after the second injection of reserpine or vehicle, the animals were observed for quantification of the behavioral parameters of oral dyskinesia: tongue protrusion and vacuous chewing movement frequencies and duration of twitching of the facial musculature. Phenomenologically, control old rats and reserpine-treated adult animals showed very similar oral dyskinesia. When compared to control adult rats, the significant increase in tongue protrusion frequency induced by reserpine treatment was more persistent in the old rats than in the adult animals. Because it is well known that age increases the persistence of tardive dyskinesia, our data provide further support for the validation of reserpine-induced oral dyskinesia as an animal model of tardive dyskinesia. In addition, the possibility is raised that a common pathophysiological mechanism may underlie tardive dyskinesia and age- and reserpine-induced oral dyskinesia.