Organ Dysfunction among Piglets Treated with Inhaled Nitric Oxide and Intravenous Hydrocortisone during Prolonged Endotoxin Infusion |
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Authors: | Sofie Paues G?ranson Waldemar Go?dzik Piotr Harbut Stanis?aw Ryniak Stanis?aw Zielinski Caroline Gillis Haegerstrand Andrzej Kübler G?ran Hedenstierna Claes Frostell Johanna Albert |
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Institution: | 1. Department of Anesthesia and Intensive Care, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.; 2. Department of Anesthesiology and Intensive Therapy, Wroclaw University of Medicine, Wroclaw, Poland.; 3. Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.; Biological Research Centre of the Hungarian Academy of Sciences, Hungary, |
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Abstract: | ObjectiveIt has previously been shown that a combination of inhaled nitric oxide (iNO) and intravenous (IV) steroid attenuates endotoxin-induced organ damage in a 6-hour porcine endotoxemia model. We aimed to further explore these effects in a 30-hour model with attention to clinically important variables.DesignRandomized controlled trial.SettingUniversity animal laboratory.SubjectsDomestic piglets (n = 30).InterventionsAnimals were randomized into 5 groups (n = 6 each): 1) Controls, 2) LPS-only (endotoxin/lipopolysaccharide (LPS) infusion), 3) LPS + iNO, 4) LPS + IV steroid, 5) LPS + iNO + IV steroid.Measurements and Main ResultsExposure to LPS temporarily increased pulmonary artery mean pressure and impeded renal function with elevated serum creatinine and acidosis compared to a control group over the 30-hour study period. Double treatment with both iNO and IV steroid tended to blunt the deterioration in renal function, although the only significant effect was on Base Excess (p = 0.045). None of the LPS + iNO + IV steroid treated animals died during the study period, whereas one animal died in each of the other LPS-infused groups.ConclusionsThis study suggests that combined early therapy with iNO and IV steroid is associated with partial protection of kidney function after 30 hours of experimental LPS infusion. |
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