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We evaluated the endothelin-1 (ET-1) and thrombin involvement in cardiovascular and respiratory dysfunction during endotoxic shock in 18 anaesthetized, mechanically ventilated pigs, divided into three groups. Group 1 was pre-treated only with lipopolysaccharide (LPS), group 2 was treated with lepirudin, a thrombin inhibitor, group 3 was pre-treated with bosentan, a dual inhibitor of ET-1 receptors. Results show that LPS caused systemic hypotension, pulmonary biphasic hypertension, increase in lung resistances (R(L)) and decrease in compliance (C(L)). Lepirudin partially reduced the LPS-dependent pulmonary hypertension, without affecting the changes in C(L) and R(L). On the contrary, bosentan completely abolished the pulmonary hypertension and the changes inC(L) and R(L), and worsened the LPS-dependent systemic hypotension. Our results show that ET-1 is largely responsible for pulmonary derangement due to endotoxic shock; at bronchial level, the ET-1 release seems due only to LPS, while, at pulmonary vascular level, it results also from LPS-dependent thrombin activation.

In a porcine model of endotoxic shock, we evaluated the circulatory and respiratory effects of NO synthase (NOS) blockade. Twenty anaesthetised pigs were divided into three groups and studied for 240 min after induction of endotoxic shock with lipopolysaccharides of Escherichia coli (LPS). After 180 min of endotoxic shock, one group (n = 6) received aminoguanidine, another group (n = 6) received N(G)-nitro-L -arginine methyl ester (L -NAME) and a third group (n = 8) received only LPS. A sham group (n = 3) was also studied. LPS decreased systemic arterial pressure and cardiac output (CO) and increased mean pulmonary arterial pressure (MPAP), pulmonary vascular resistance (PVR) and heart rate. Significant changes were also observed in compliance (-18.4%) and resistance (+33.6%) of the respiratory system. Aminoguanidine did not modify LPS-dependent effects, while, after L -NAME, a significant increase in MPAP, PVR and SVR and a decrease in CO were observed. In conclusion, aminoguanidine does not play a significant cardiocirculatory and pulmonary role in the short-term dysfunction of endotoxic shock, while L -NAME has a detrimental effect on haemodynamics, suggesting a protective role of constitutive NO production at vascular level during the early stages of endotoxaemia.

To evaluate the role of endothelin (ET) in respiratory homeostasis we studied the effects of the ET(A) and ET(B) receptor blocking agent bosentan on respiratory mechanics and control in seven anaesthetised spontaneously breathing pigs, for 180 min after single bolus administration (20 mg/kg i.v.). The results show that the block of ET receptors induced a significant increase in compliance and decrease in resistance of the respiratory system, entailing a significant reduction of diaphragmatic electromyographic activity, without affecting the centroid frequency of the power spectrum. Bosentan administration induced a significant increase in tidal volume (V(T)), accompanied by a significant decrease in respiratory frequency, without any significant change in pulmonary ventilation, CO(2) arterial blood gas pressure or pH. Since the relationship between V(T) and inspiratory time remained substantially constant after bosentan administration, the changes in respiratory pattern appear to be the result of an upward shift in inspiratory off-switch threshold. Both inspiratory and expiratory times during occluded breathing were increased by block of ET receptors, suggesting also a central respiratory neuromodulator effect of ET. In conclusion the present results suggest that the block of ET receptors in spontaneously breathing pigs exerts a role on mechanical properties of the respiratory system as well as on peripheral and central mechanisms of breathing control., (Copyright 2001 Harcourt Publishers Ltd.)

We evaluated the role of endothelin-1 (ET-1) and the involvement of nitric oxide in cardiovascular and respiratory dysfunction, during endotoxic shock, in 18 anaesthetised, mechanically ventilated pigs, divided into three groups. Group 1 was i.v. infused with LPS (20 microg/Kg/h for 240 min). Group 2 was pre-treated with bosentan, a dual inhibitor of ET-1 receptors, and at 180 min of endotoxic shock, L-NAME (N(G)-nitro-L-arginine methyl ester, 10 mg/Kg), a non-selective inhibitor of NO synthases, was i.v. administered. Group 3 was infused with LPS and L-NAME was administered similarly to group 2. Results show that LPS caused systemic hypotension, pulmonary biphasic hypertension, decrease in compliance (C(rs)) and increase in resistance (R(max,rs)) of respiratory system. Bosentan completely abolished the pulmonary hypertension and the changes in C(rs)and R(max,rs). L-NAME does not affect the LPS-dependent changes in respiratory mechanics, but it worsens the cardiovascular effects, causing death of pigs. Pre-treatment with bosentan prevents this deleterious effect. Our study demonstrates that the LPS-dependent respiratory effects are mediated by ET-1, which, probably causing pulmonary oedema, is responsible for the decrease in C(rs)and the increase of R(max,rs)., (Copyright 2001 Harcourt Publishers Ltd.)

This study investigated the mechanisms that may contribute to the hypoxic pulmonary vasoconstriction and compared the effects of hypoxia on pulmonary and systemic vascular beds. Six anesthetized spontaneously breathing pigs inhaled a hypoxic mixture (10% O2 in air) in control conditions and after pre-treatment with Indomethacin (3 mg kg(-1) i.v.) to block the cyclooxygenase pathway. During hypoxia, the Indomethacin pre-treated pigs were given Cromakalim (80 microg kg(-1) i.v.) to activate K+(ATP) channels. Bosentan (5 mg kg(-1) i.v.) was administered to block endothelin-1 receptors and then during hypoxia Cromakalim was administered as before. In all experimental conditions we recorded breathing pattern and vascular parameters: mean systemic and pulmonary arterial pressures; systemic and pulmonary vascular resistances; cardiac output; and heart rate. Vascular and respiratory responses to hypoxia were determined when PaO2 was reduced to 50 +/- 5 mmHg. The main finding was that in spontaneously breathing pigs, hypoxia induces pulmonary vasoconstriction and an increase in mean systemic arterial pressure, which are cyclooxygenase-independent. A role of endothelin-1 appears in both vascular districts, but pulmonary vasoconstriction may also be due to ET-1-dependent inhibition of K+(ATP) channels.

In 12 anaesthetized spontaneously breathing pigs divided into two groups of six animals we evaluated the respiratory and haemodynamic responses to endothelin-1 (ET-1) administered by aerosol (200 pmol x kg(-1) in 1 ml of saline solution). In the first group (control group), the responses to ET-1 were evaluated before and after the blocking of endogenous nitric oxide (NO) by NG-nitro-L-arginine methyl ester (L-NAME 5 mg x kg(-1), i.v.). In the second group (indomethacin-pretreated group), the experimental protocol was similar to that of the control group, but the responses were evaluated after the blocking of endogenous prostanoids by indomethacin (3 mg x kg(-1), i.v.). Results show that in the control group ET-1 administered before and after L-NAME did not change compliance (Crs) or resistances (Rrs) of the respiratory system. In indomethacin-pretreated pigs, ET-1 significantly increased Rrs and decreased Crs. This constrictor effect appearing only during the block of arachidonic acid metabolites showed that ET-1 activity can be counterbalanced by a release of dilator prostanoids. In this group after L-NAME pretreatment ET-1 did not alter the mechanical properties of the respiratory system, suggesting an involvement of other bronchodilator mechanisms. In the control group, aerosol administered ET-1 increased mean systemic (MAP) and pulmonary (MPAP) arterial pressures, while when ET-1 was administered after L-NAME pretreatment, MPAP decreased. In the indomethacin-pretreated group, the peptide did not modify MAP, but caused an early decrease in MPAP when administered after L-NAME. Therefore, our results show that ET-1 caused a bronchoconstrictor effect only in indomethacin-pretreated pigs and suggest that the intrinsic constrictor activity of the peptide can be modulated especially by the release of dilator prostanoids.

The vascular effects of endothelin-1 (ET-1) and the release of prostacyclin and nitric oxide (NO) evoked by this peptide were analyzed in anesthetized, mechanically ventilated pigs. ET-1 induced biphasic responses in both the pulmonary and systemic vascular beds characterized by a transient hypotension followed by a long-lasting hypertension. To evaluate the involvement of prostacyclin and NO in the ET-1-dependent vascular response, we used indomethacin to block cyclooxygenase and NG-nitro-L-arginine methyl ester (L-NAME) to block NO synthase. The results show that the systemic hypotensive response to ET-1 is mediated by the release of prostanoids and NO, but these are not responsible for the pulmonary hypotension. Indomethacin reduced the hypertensive effect of ET-1, showing that this peptide can also activate release of vasoconstrictor cyclooxygenase metabolites. When L-NAME was administered after indomethacin, the pulmonary vasoconstrictor activity of ET-1 was counterbalanced by NO. By contrast, in pigs pretreated with indomethacin plus L-NAME ET-1 caused transient systemic vasoconstriction, followed by progressive reduction of vascular tone, probably because of release of vasodilator agents other than prostanoids or NO.

In anesthetized, ventilated pigs we analyzed the involvement of nitric oxide (NO) and prostaglandins (PGs) in the regulation of systemic and pulmonary basal vascular tone. Endogenous release of NO was blocked by NG-nitro-L-arginine methyl ester (L-NAME) and prostanoid biosynthesis by indomethacin. Blocking NO raised pulmonary and systemic arterial pressure and vascular resistances. These effects show that in the pig there is continuous release of minute amounts of NO. Blocking prostanoid biosynthesis did not affect the vasoconstrictor effect of L-NAME on the pulmonary vascular bed, but significantly strengthened the hypertensive effect of L-NAME on the systemic vascular bed. These data show that different mechanisms regulate pulmonary and systemic vascular tone. Administration of a stable analogue of PGI2 to pigs pretreated with indomethacin reversed the systemic vasoconstrictor effect of L-NAME. In conclusion, our data show that NO especially modulates pulmonary vascular tone, while PGI2 preferentially modulates systemic vascular tone.

In six anesthetized, paralyzed, mechanically ventilated pigs we evaluated the respiratory effects of inhaled nitric oxide (NO) (80 ppm in O2) under control conditions and after platelet-activating factor (PAF) administration (50 ng/kg, i.v.). PAF was also administered to the same pigs after pretreatment with indomethacin (3 mg/kg, i.v.). The mechanical properties of the respiratory system were evaluated by the rapid airway occlusion technique. With this technique the overall respiratory resistances, the airway resistances, and the additional resistances of respiratory system and lung can be evaluated. The results show that NO inhaled by the pig at 80 ppm for 6 min under control conditions reduced static and dynamic elastances of the respiratory system and lung and pulmonary arterial pressure, without modifying bronchomotor tone. Therefore, NO reduced the PAF-dependent changes in resistances and in static and dynamic elastances of the respiratory system and lung. The modest change in elastances caused by PAF in pigs pretreated with indomethacin was reduced by NO inhalation, which also has a mild bronchodilatory effect. The changes in elastances appear to be correlated with the pulmonary vasodilator activity of inhaled NO.

In 6 anesthetized mechanically ventilated pigs we have studied the effects of inhalation of 80 ppm of nitric oxide (NO) before and after platelet-activating factor (PAF) administration (50 ng/kg iv). Our results show that NO inhalation causes a decrease in pulmonary arterial pressure and in heart rate without affecting other circulatory parameters. PAF administration causes a pulmonary hypertension and a prompt and brief decrease in systemic pressure. Inhalation of NO reduces the pulmonary hypertension, without completely reversing PAF-dependent vasoconstriction. PAF administration to pigs pretreated with indomethacin produces a lesser increase in pulmonary vascular pressure. In this case, NO inhalation can restore to baseline values. Pretreatment of 3 of the 6 pigs with NG-nitro-L-arginine-methyl-ester did not prevent the prompt and brief PAF-induced systemic hypotension. In conclusion, our results show that NO reduces basal pulmonary vascular tone, acts as a pulmonary vasodilator on PAF-preconstricted vessels and is not involved in the brief systemic hypotension consequent to PAF administration.

In intact and vagotomized anesthetized, spontaneously breathing piglets, we investigated the regulation of inspiratory timing evoked by i.v. administration of prostaglandin (PG) F2 alpha. The inspiratory time was evaluated from the flow trace as an index of mechanical inspiratory time (Ti) and from costal and crural diaphragmatic EMG (TiEMG) as an index of neural inspiratory time. Our results under control conditions showed that TiEMG was shorter than Ti. Vagotomy abolished the difference, inducing a change in the power spectrum without modifying the centroid frequency (Cf). PGF2 alpha lengthened TiEMG, causing a postinspiratory diaphragmatic discharge to appear, while mechanical inspiratory time decreased significantly. Postvagotomy i.v. administration of PGF2 alpha did not cause any significant changes in inspiratory time and did not evoke the postinspiratory discharge. The i.v. administration of PGF2 alpha before and after vagotomy did not change the centroid frequency in spite of recruitment of new motor units synchronized with those that are active under control conditions.

In 14 anesthetized, spontaneously breathing pigs we examined the changes in breathing pattern, in respiratory mechanics and in systemic and pulmonary vascular parameters after i.v. PAF administration. In another 3 pigs, the effects of PAF were also examined after bilateral vagotomy. In intact pigs, PAF induces apnea, bronchoconstriction, pulmonary hypertension and systemic hypotension. Our results also show that administration of PAF alters the phasic vagal activity, modifying the slope of VT vs TI and TE vs TI relationships and the TI0/TI ratio. These effects and apnea are vagus-dependent. The central excitatory timing effect of PAF on inspiratory duration (TI0) was correlated with a decrease in passive compliance but not with active compliance. We postulate that the activation by vagal input strengthens the mechanisms that counteract the bronchoconstrictor effect of PAF.

We investigated the effects of PGF2 alpha on the breathing patterns and electric activity of costal and crural parts of the diaphragm in 9 anesthetized newborn pigs. The change in diaphragmatic tension was evaluated as the change in transdiaphragmatic pressure. Because PGF2 alpha induces bronchoconstriction and an increase in respiratory resistances, the changes induced by prostaglandin were evaluated as differences between bronchoconstriction after PGF2 alpha and resistive load obtained by applying gradual occlusion to the inspiratory line of the breathing circuit. Our results show that PGF2 alpha decreased respiratory frequency with lengthening of expiratory time, while the resistive load increased both respiratory phases. The changes in breathing pattern were associated with different electrical activities of the diaphragm. While resistive load did not significantly change the EMG power spectrum, PGF2 alpha recruited new motor units. Furthermore, resistive load induced synchronization of the inspiratory time discharge of the costal and crural parts of the diaphragm, while after PGF2 alpha infusion there was an early inspiratory discharge of the crural part.

The effect of PGF2 alpha has been evaluated in 11 unanaesthetized unrestrained piglets and in 3 anaesthetized piglets (2-3 days old) using a barometric-plethysmographic technique. PGF2 alpha (mg 0.25/pig) was administered as aerosol for 5 min. In 3 of the unanaesthetized newborn pigs the effect of PGF2 alpha aerosol has been evaluated after indomethacin (mg 1/Kg i.v.). The vagal dependent activity of the prostaglandin was also evaluated after atropine (mg 0.08/Kg i.m.). Our results show that PGF2 alpha in newborn pigs causes hypoventilation due to a decrease in respiratory rate and to a lengthening in TE. The changes in TE are due to an increase in the incidence and duration of apneic events characterizing the respiratory activity at birth. After indomethacin PGF2 alpha does not change the breathing pattern. Atropine only partially reduces the effects of PGF2 alpha while, after anaesthesia, prostaglandin does not change the breathing pattern. Consequently our results show that PGF2 alpha in newborn animals similar to other prostaglandins acts as a depressant of respiratory activity.