Lee C C, Sugerman H J, Tatum J L, Wright T P, Hirsh P D, Hirsch J I
J Surg Res. 1986 May;40(5):438-44. doi: 10.1016/0022-4804(86)90212-x.
The effects of ibuprofen (I) were studied in the Pseudomonas (P) porcine ARDS model. Pigs, 14-26 kg (5 in each group), were anesthetized and ventilated with 0.5 FiO2 and 5 cm H2O PEEP. A control (C) group received saline only, a second group was given P, 1 X 10(8) org/ml at 0.3 cc/20 kg/min, and a third group was given P followed by 12.5 mg I at 20 and 120 min. Pulmonary arterial (PAP), wedge (PWP) and systemic arterial pressures, cardiac output (CO), and thermal-cardiogreen extravascular lung water (EVLW), thromboxane (TxB2), 6-keto-PGF1 alpha, PaO2, PaCO2 were determined every 30 min. Albumin flux was measured with scintigraphic determination of lung:heart radioactivity ratios versus time, called slope index (SI). At 3 hr, P produced marked (P less than 0.05) increases in PAP (18 +/- 7 to 37 +/- 2 mm Hg), TxB2 (471 +/- 513 to 9216 +/- 3615 pg/ml), 6-keto-PGF1 alpha, EVLW (6.4 +/- 1.4 to 14.6 +/- 5.7 mg/kg), and SI (0.4 +/- 0.2 to 1.7 +/- 0.5 X 10(-3) U/min) with decreases in PaO2 (214 +/- 47 to 101 +/- 41 torr), CO and SAP. Ibuprofen caused a rapid clearing of TxB2 and 6-keto-PGF1 alpha associated with a transient decrease in PAP; PaO2 was considerably improved compared to P; however, CO, SAP, EVLW, and SI were unaffected. Prostaglandin blockage temporarily ameliorated the pulmonary hypertension and markedly improved oxygenation in this porcine septic ARDS model, but failed to alter increased permeability, confirming other studies that the increased pulmonary shunt in ARDS is not only dependent upon capillary leak.
在猪的铜绿假单胞菌（P）诱导的急性呼吸窘迫综合征（ARDS）模型中研究了布洛芬（I）的作用。选用体重14 - 26千克的猪（每组5只），进行麻醉并给予0.5的吸入氧分数（FiO2）和5厘米水柱的呼气末正压通气（PEEP）。对照组（C）仅给予生理盐水，第二组给予P，剂量为1×10⁸ 菌落形成单位/毫升，输注速度为0.3毫升/20千克体重/分钟，第三组先给予P，然后在20分钟和120分钟时给予12.5毫克I。每30分钟测定一次肺动脉压（PAP）、肺楔压（PWP）、体动脉压、心输出量（CO）、热稀释法测定的心绿蛋白血管外肺水（EVLW）、血栓素（TxB2）、6 - 酮 - 前列环素F1α（6 - keto - PGF1α）、动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）。通过闪烁显像法测定肺与心脏放射性比值随时间的变化来测量白蛋白通量，称为斜率指数（SI）。3小时时，P导致PAP显著升高（从18±7毫米汞柱升至37±2毫米汞柱，P＜0.05）、TxB2升高（从471±513皮克/毫升升至9216±3615皮克/毫升）、6 - keto - PGF1α升高、EVLW升高（从6.4±1.4毫克/千克升至14.6±5.7毫克/千克）以及SI升高（从0.4±0.2×10⁻³单位/分钟升至1.7±0.5×10⁻³单位/分钟），同时PaO2降低（从214±47托降至101±41托）、CO和体动脉压（SAP）降低。布洛芬使TxB2和6 - keto - PGF1α迅速清除，同时PAP短暂下降；与P组相比，PaO2有显著改善；然而，CO、SAP、EVLW和SI未受影响。在该猪脓毒症ARDS模型中，前列腺素阻断可暂时改善肺动脉高压并显著改善氧合，但未能改变通透性增加的情况，这证实了其他研究结果，即ARDS中肺内分流增加不仅取决于毛细血管渗漏。
