Effects Of Inhalation Of Aerosol Iloprost During Partial Liquid Ventilation On The Oleic Acid-induced Acute Lung Injury In Rabbits.

The pathophysiological hallmarks of acute lung injury (ALI)/acute respiratory distress syndrome(ARDS) are: alveolar collapse and atelectasis, lung interstitial edema and fibrosis and ventilation-perfusion mismatch; these result in pulmonary hypertension (PH) and elevated intrapulmonary shunt in the dependent regions. Its clinical manifestation is refractory hypoxemia and respiratory distress.Partial liquid ventilation (PLV) for above pathophysiologic alteration can improve gas exchange and pulmonary compliance and decrease lung tissue damage. However, the current studies failed to identify that PLV can obviously improve pulmonary hypertension, for this reason we can not evaluate the favorable effect by PLV alone.Pulmonary hypertension may result in intrapulmonary hypoperfusion, which can aggravate ventilation-perfusion mismatching and degrade arterial oxygen. Currently, vasodilators (such as NO, PGI2) have been used to treat acute respiratory failure caused by PH. Since inhalation of vasodilators can selectively dilate pulmonary vessel to improve pulmonary circulation and match ventilation-perfusion, Iloprost is the optimal option to step down ALI pulmonary hypertension. However, its effect on pulmonary gas exchange is sometimes difficult to predict in severe lung injury. This limited effect may be partly explained by lack of adequate recruitment of the gas exchange unit.According to the analysis, the combination treatment of PLV with inhalation of Iloprost can not only recruit collapsed alveoli, ameliorate pulmonary compliance and decrease further lung tissue damage, but also augment the effect of inhaled Iloprost to dilate pulmonary vessel and match ventilation-perfusion which can improve pulmonary gas exchange and decrease pulmonary pressure. Therefore, in this experiment, based on the model of modified oleic acid-induced acute lung injury, we have combined PLV with...