Prevention of hemodilution-induced inhibition of hypoxic pulmonary vasoconstriction by N-acetylcysteine in dogs

F Kerbaul, P Van der Linden, S Pierre… - Anesthesia & …, 2004 - journals.lww.com
F Kerbaul, P Van der Linden, S Pierre, B Rondelet, C Melot, S Brimioulle, R Naeije
Anesthesia & Analgesia, 2004journals.lww.com
IMPLICATIONS: Hemodilution inhibits hypoxic pulmonary vasoconstric-tion. This study
showed that this potential cause of altered gas exchange is partly explained by viscosity
changes and is completely preventable by the administration of the reactive oxygen species
scavenger N-acetylcysteine. Isovolemic hemodilution is currently used to reduce blood
transfusion requirements during surgery (1). However, a decrease in hematocrit inhibits
hypoxic pulmonary vasoconstriction (HPV)(2–6). Therefore, hemodilution could alter the …
IMPLICATIONS: Hemodilution inhibits hypoxic pulmonary vasoconstric-tion. This study showed that this potential cause of altered gas exchange is partly explained by viscosity changes and is completely preventable by the administration of the reactive oxygen species scavenger N-acetylcysteine.
Isovolemic hemodilution is currently used to reduce blood transfusion requirements during surgery (1). However, a decrease in hematocrit inhibits hypoxic pulmonary vasoconstriction (HPV)(2–6). Therefore, hemodilution could alter the matching of pulmonary perfusion (𝑄̇) to alveolar ventilation in hypoxic lung regions. Accordingly, hemodilution has been reported to increase pulmonary shunt in rabbits with left lung atelectasis (7). Thus, hemodilution could contribute to the alteration of pulmonary gas exchange and resulting hypoxemia often observed with general anesthesia.
Lippincott Williams & Wilkins