Byrne K, Carey P D, Sielaff T D, Jenkins J K, Blocher C R, Cooper K R, Fowler A A, Sugerman H J
Department of Surgery, Medical College of Virginia, Virginia Commonwealt University, Richmond 23298-0519.
J Trauma. 1991 Feb;31(2):155-64; discussion 165-6.
The effects of intravenous ibuprofen on measurements of pulmonary function and alveolar capillary membrane permeability to protein in sepsis-induced porcine acute lung injury (ALI) were studied. Young swine (15-25 kg) were anesthetized, cannulated, and ventilated (5 cm H2O PEEP, 0.5 FIO2, and 15 cc/kg tidal volume). Three groups were studied: septic animals (Ps, n = 10) received Pseudomonas aeruginosa for 1 hr IV, controls (C, n = 9) received 0.9% NaCl, and ibuprofen-treated septic animals (Ps + Ibu, n = 7) received ibuprofen 12.5 mg/kg at 0 and 120 min post Ps. Systemic (SAP) and pulmonary (PAP) arterial pressures, PaO2, cardiac index (CI), static lung compliance (CL), EVLW (thermal cardiogreen), and peripheral white blood cell counts (WBC) were measured. Bronchoalveolar lavage (BAL) was performed for protein and % neutrophil (%PMN) content.
Ps produced significant (p less than 0.05) decreases in CL, PaO2, SAP, CI, and peripheral WBC and increases in PAP, EVLW, BAL protein, and %PMN's vs. controls. Ibu prevented the early increase in PAP and attenuated the late increase in PAP and EVLW. Ibu also maintained PaO2, CL, BAL protein, and %PMN's in BAL at control levels, but exhibited no significant effect on peripheral leukopenia. These data strongly suggest that ibuprofen administered before and at 120 min after onset of Pseudomonas infusion improves lung compliance and affects neutrophil function sufficiently to significantly ameliorate many of the physiologic derangements in acute sepsis.
研究了静脉注射布洛芬对脓毒症诱导的猪急性肺损伤（ALI）中肺功能测量以及肺泡毛细血管膜对蛋白质通透性的影响。将年轻猪（15 - 25千克）麻醉、插管并进行通气（呼气末正压5厘米水柱、吸入氧分数0.5、潮气量15毫升/千克）。研究了三组：脓毒症动物组（Ps，n = 10）静脉注射铜绿假单胞菌1小时，对照组（C，n = 9）接受0.9%氯化钠，布洛芬治疗的脓毒症动物组（Ps + Ibu，n = 7）在静脉注射铜绿假单胞菌后0分钟和120分钟接受12.5毫克/千克布洛芬。测量了体循环动脉压（SAP）和肺循环动脉压（PAP）、动脉血氧分压（PaO2）、心脏指数（CI）、静态肺顺应性（CL）、血管外肺水（EVLW，热稀释法）以及外周白细胞计数（WBC）。进行支气管肺泡灌洗（BAL）以检测蛋白质和中性粒细胞百分比（%PMN）含量。
与对照组相比，脓毒症动物组的CL、PaO2、SAP、CI和外周白细胞显著降低（p < 0.05），而PAP、EVLW、BAL蛋白质和%PMN增加。布洛芬可预防PAP早期升高，并减轻PAP和EVLW的后期升高。布洛芬还能将BAL中的PaO2、CL、BAL蛋白质和%PMN维持在对照水平，但对外周白细胞减少无显著影响。这些数据强烈表明，在静脉注射铜绿假单胞菌之前及之后120分钟给予布洛芬可改善肺顺应性，并充分影响中性粒细胞功能，从而显著改善急性脓毒症中的许多生理紊乱。
