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Cardiopulmonary effects of iloprost in experimental acute lung injury

Dept of Anaesthesiology, University Hospital Aachen, Aachen, Germany

CORRESPONDENCE: R. Dembinski, Dept of Anaesthesiology, University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany. Fax: 49 2418888406. E-mail: Rolf.Dembinski@post.rwth-aachen.de

Keywords: Acute lung injury, animal model, haemodynamics, prostacyclin, pulmonary gas exchange

Received: July 20, 2004
Accepted September 10, 2004

Iloprost, a prostacyclin analogue with a prolonged plasma half-life has beneficial effects in chronic pulmonary hypertension, whereas the effects in acute lung injury (ALI) are unknown. The present study was performed to evaluate the cardiopulmonary effects of iloprost in experimental ALI.

ALI was induced in 18 pigs by repeated lung lavage. Animals were randomised to controls, i.v. or inhaled iloprost for 15 min. Haemodynamics, gas exchange and ventilation–perfusion distribution were measured at the end of iloprost application and after 1 and 2 h.

As a short-term effect, both i.v. and inhaled iloprost significantly decreased pulmonary artery pressure without major effects on gas exchange or systemic haemodynamics. After 1 and 2 h, a reduction of pulmonary hypertension was no longer present. As a long-term effect, inhaled, but not i.v., iloprost decreased pulmonary shunt and significantly improved gas exchange after 1 and 2 h.

In conclusion, the single application of iloprost revealed short-term pulmonary vasodilation without other major cardiopulmonary effects. However, inhaled iloprost improved gas exchange due to a decrease of pulmonary shunt as a long-term effect, possibly as a result of a reduction of lung oedema formation.