Comparison of inhaled milrinone, nitric oxide and prostacyclin in acute respiratory distress syndrome

Albert, Martin; Corsilli, Daniel; Brosseau, Marc; Bellemare, Patrick; Delisle, Stéphane; Nguyen, Anne Qn

doi:10.5492/wjccm.v6.i1.74

Cited by 16 publications

(10 citation statements)

References 12 publications

(14 reference statements)

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“…Ulinastatin, as a kind of broad-spectrum protease inhibitor, can effectively inhibit the activity of inflammatory factors and reduce their levels, thus playing a role in protecting the body organs and system ( 14 ). Its intravenous administration can effectively inhibit a variety of cell proteolytic enzymes in the body ( 15 ), reduce the damage of hydrolase to normal tissues, stabilize the intracellular lysosomal membrane, and reduce the body peroxidation reaction by inhibiting the production of peroxide, thus inhibiting the inflammatory response ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

Effects of ulinastatin combined with mechanical ventilation on oxygen metabolism, inflammation and stress response and antioxidant capacity of ARDS

Ji¹,

Chen²,

Wang³

et al. 2018

Exp Ther Med

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Acute respiratory distress syndrome (ARDS) is a disease that seriously threatens human life and health. The aim of the study was to investigate the effects of ulinastatin combined with mechanical ventilation on oxygen metabolism, inflammation and stress response, as well as the antioxidant capacity of ARDS. Eighty patients with ARDS treated in Yiwu Central Hospital from January, 2015 to December, 2016 were enrolled in the present study and divided into the observation (n=40) and control (n=40) groups, using a random number table. The control group was treated with mechanical ventilation, while the observation group, based on treatment of the control group, was treated with ulinastatin for 14 consecutive days as one course of treatment. The changes in the relevant indexes of oxygen metabolism, lung function, time of ventilator treatment, total hospital stay, and St. George's Respiratory Questionnaire (SGRQ) score of the two groups after intervention were compared, and the changes in inflammatory cytokine levels, dopamine receptor-related hormone levels, superoxide dismutase (SOD), malondialdehyde (MDA) and total antioxidant capacity of the two groups before intervention and at 1 and 4 weeks after intervention were compared. After intervention, the arterial blood lactate in the observation group was significantly lower than that in the control group (P<0.05), the oxygen uptake rate was significantly higher than that in the control group (P<0.05) and the arterial oxygen content was significantly higher than that in the control group (P<0.05). In the lung function indexes, the FEV1 and FEV1/FVC levels in the observation group were smaller than those in the control group (P<0.05), the duration of ventilator treatment was significantly shorter than that in the control group (P<0.05), and the hospital stay was significantly less than that in the control group (P<0.05). Prior to intervention, SGRQ scores in the two groups were not statistically significant (P>0.05). At 1 and 4 weeks after intervention, the SGRQ scores of the observation group were significantly increased to those of the control group (P<0.05). The tumor levels of necrosis factor-α (TNF-α), interleukin-6 (IL-6) and CRP were significantly lower than those of the control group (P<0.05). The levels of adrenaline and norepinephrine were significantly lower than those of the control group (P<0.05). The levels of MDA, SOD and the total antioxidant capacity were significantly increased to those of control group (P<0.05). The application of ulinastatin combined with mechanical ventilation in ARDS patients is of great significance in improving the oxygen delivery-consumption balance of body, increasing the lung function, reducing the inflammatory and stress response, and improving the antioxidant capacity.

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Section: Discussionmentioning

confidence: 99%

Effects of ulinastatin combined with mechanical ventilation on oxygen metabolism, inflammation and stress response and antioxidant capacity of ARDS

Ji¹,

Chen²,

Wang³

et al. 2018

Exp Ther Med

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“…In an open‐label prospective crossover pilot study, breathing 20 p.p.m. of NO significantly improved oxygenation in 15 adult patients with ARDS (Albert et al ., 2017). Accumulating evidence suggests that NO inhalation therapy is beneficial in patients with ARDS.…”

Section: Inhaled No In Acute Respiratory Distress Syndromementioning

confidence: 99%

Inhaled nitric oxide

Ichinose

Bloch

et al. 2018

British J Pharmacology

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Nitric oxide (NO) is a gas that induces relaxation of smooth muscle cells in the vasculature. Because NO reacts with oxyhaemoglobin with high affinity, the gas is rapidly scavenged by oxyhaemoglobin in red blood cells and the vasodilating effects of inhaled NO are limited to ventilated regions in the lung. NO therefore has the unique ability to induce pulmonary vasodilatation specifically in the portions of the lung with adequate ventilation, thereby improving oxygenation of blood and decreasing intrapulmonary right to left shunting. Inhaled NO is used to treat a spectrum of cardiopulmonary conditions, including pulmonary hypertension in children and adults. However, the widespread use of inhaled NO is limited by logistical and financial barriers. We have designed, developed and tested a simple and economic NO generation device, which uses pulsed electrical discharges in air to produce therapeutic levels of NO that can be used for inhalation therapy. Linked Articles This article is part of a themed section on Nitric Oxide 20 Years from the 1998 Nobel Prize. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.2/issuetoc

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“…However, NO also activates protein kinase G (PKG), through the no/cyclic guanosine monophosphate/PKG pathway (45). additionally, phosphorylated p38 mitogen-activated protein kinase activates caspase-3 (46).…”

Section: Discussionmentioning

confidence: 99%

Effects of simvastatin on iNOS and caspase‑3 levels and oxidative stress following smoke inhalation injury

Yang

Guo

et al. 2020

Mol Med Rep

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The overexpression of inducible nitric oxide synthase (inoS) induces cell apoptosis through various signal transduction pathways and aggravates lung injury. caspase-3 is an important protein in the apoptotic pathway and its activation can exacerbate apoptosis. Simvastatin, a hydroxymethyl glutaryl-a reductase inhibitor, protects against smoke inhalation injury by inhibiting the synthesis and release of inflammatory factors and decreasing cell apoptosis. Following the establishment of an animal model of smoke inhalation injury, lung tissue and serum were collected at different time points and the protein and mrna expression of inoS and caspase-3 in lung tissue by immunochemistry, western blot and reverse transcription-quantitative polymerase chain reaction, the malondialdehyde (Mda) content and superoxide dismutase (Sod) activity in lung tissue and serum were analyzed using thiobarbituric acid method and the WST-1 method. The results were statistically analyzed. The lung tissues of the rats in the saline group and the low-, middle-and high-dose groups exhibited clear edema and hemorrhage, and had significantly higher pathological scores at the various time points compared with the rats in the control group (P<0.05). Furthermore, lung tissue and serum samples obtained from these four groups had significantly higher mRNA and protein expression levels of iNOS and caspase-3 (P<0.05), significantly lower SOD activity and higher Mda content (P<0.05). compared with the saline group, the low-, middle-and high-dose groups had significantly lower pathological scores (P<0.05), significantly lower mrna and protein expression levels of inoS, caspase-3 and MDA content in lung tissues (P<0.05) and significantly higher Sod activity in lung tissues and serum. The middle-and high-dose groups had significantly lower pathological scores (P<0.05), significantly decreased iNOS and caspase-3 mRNA and protein expression in lung tissues, significantly higher SOD activity in lung tissues and serum and a significantly lower Mda content (P<0.05) compared with the low-dose group. With the exception of Sod activity in lung tissues at 24 and 72 h and MDA content in serum at 48 h, no significant differences were observed between the middle-and high-dose groups. The present study demonstrated that there was an association between the therapeutic effect and dosage of simvastatin within a definitive range. In rats with smoke inhalation injury, simvastatin inhibited inoS and caspase-3 expression in lung tissues and mitigated oxidative stress, thereby exerting a protective effect. in addition, the effect and dose were associated within a definitive range.

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Comparison of inhaled milrinone, nitric oxide and prostacyclin in acute respiratory distress syndrome

Cited by 16 publications

References 12 publications

Effects of ulinastatin combined with mechanical ventilation on oxygen metabolism, inflammation and stress response and antioxidant capacity of ARDS

Effects of ulinastatin combined with mechanical ventilation on oxygen metabolism, inflammation and stress response and antioxidant capacity of ARDS

Inhaled nitric oxide

Effects of simvastatin on iNOS and caspase‑3 levels and oxidative stress following smoke inhalation injury

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