EFFECTS OF BRONCHODILATOR INHALATION ON LUNG MECHANICS IN ADULT RESPIATORY DISTRESS SYNDROME: EXPERIMENTAL STUDY

Baek,  Kwang Je; Kim,  Jun Sik

J Korean Soc Emerg Med > Volume 8(1); 1997 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 1997;8(1): 9-16.

EFFECTS OF BRONCHODILATOR INHALATION ON LUNG MECHANICS IN ADULT RESPIATORY DISTRESS SYNDROME: EXPERIMENTAL STUDY

Kwang Je Baek, Jun Sik Kim

Department Emergency Medicine, College of Medicine, Inha University, Incheon, Korea.

ABSTRACT

The acute respiratory distress syndrome (ARDS) is a disorder of diffuse lung injury secondary to a wide variety of clinical insults including sepsis. It is manifested by impaired oxygenation, pulmonary edema, decreased static and dynamic compliance of lung, and increased airway resistance. Reduced lung compliance together with increased airway resistance is a hallmark of the syndrome and has generally been considered as the primary abnormality of lung mechanics. The study was designed to reproduce an ARDS condition in an animal model with acute lung injury and to determine whether these changes are reversed by inhalation of aerosolized bronchodilator such as salbutamol or nicorandil. Six adult mongrel dogs were exposed to intravenous oleic acid (0.08 ml/kg) mixed into a same amount of pure enthanol. We defined a condition of PaO2 less than 60 mmHg in FiO2 0.6 as an acute diffuse lung injury. Lung mechanics were deteriorated after oleic acid injection, from 27.33+/-2.73 to 17.50+/-.47 cmH2O/l/sec in compliance and from 14.55+/-.46 to 26.33+/-.02 ml/cmH2O in airway resistance. Salbutamol or Nicorandil inhalation significantly improved lung compliance to 30.57+/-11.30 or 36.33+/-.00 cmH2O/l/sec and airway resistance to 16.77+/-.47 or 19.55+/-.45 ml/cmH2O. From above data, we carefully concluded that compromized lung mechanics in adult respiratory distress syndrome could be effectively managed by inhalation of aerolized bronchodilator.