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DOI: 10.1055/s-2006-925739
Cardiopulmonary effects of inhaled and i.v. administered Iloprost in experimental acute lung injury in pigs
Iloprost has beneficial effects in chronic pulmonary hypertension. Its effects in acute pulmonary hypertension i.e. in acute lung injury (ALI) are not well-known. This experimental study was performed to evaluate the cardiopulmonary effects of Iloprost in ALI.
Study design: ALI was induced in 18 pigs by repeated (18±9) lung lavages. Animals were randomised to controls, i.v. administered (80ng/kg/min) or inhaled (220ng/kg/min) Iloprost for 15min. Haemodynamics, gas exchange and intrapulmonary shunt were measured before and directly after induction of ALI, at the end of Iloprost application and after 1 and 2h.
Results: Induction of ALI resulted in significant and similar changes in all groups: decrease of the arterial partial oxygen pressure (481 ≥ 90mmHg) and increase of the mean pulmonary artery pressure (=MPAP, 22 ≥ 41mmHg) as well as the pulmonary shunt (0 ≥ 50%). The MPAP was significantly decreased directly after intravenously administered (40 ≥ 32mmHg) and inhaled (41 ≥ 31mmHg) Iloprost without major effects on systemic haemodynamics, but this effect disappeared after 1 and 2 hours. Only inhaled not intravenously administered Iloprost significantly decreased the intrapulmonary shunt and increased the arterial partial oxygen pressure (174mmHg at 1h and 220mmHg at 2h versus 86mmHg at ALI Induction).
Conclusion: 1. The single application of Iloprost causes a short-term reduction of MPAP in acute pulmonary hypertension without other major cardiopulmonary effects.
2. Only inhaled Iloprost improves the gas exchange due to a decrease of the intrapulmonary shunt. This effect may be beneficial in the treatment of ALI.