Joint effects of hydroxyethyl starch and furosemide on acute lung injury induced by paraquat in swine

Objective To discuss the jointly therapeutic effects of 6% hydroxyethyl starch 130/ 0.4 (voluven) and furosemide on acute lung injury induced by paraquat (PQ) in swine. Methods The ALI/ARDS models were established with 20% PQ (20 mL) intraperitoneal injection in 18 healthy female piglets and randomly divided into three groups: voluven group (A) , furosemide group (B) and voluven +furosemide group (C) (n=6 in each group). The heart rate (HR) , mean arterial pressure (MAP) , extravascular lung water index (ELWI) , pulmonary vascular permeability index (PVPI) , partial pressure of carbon dioxide (PaCO2) and oxygenation index (PaO2/FiO2) among the three groups were carefully measured by PICCO (pulse indicator continuous cardiac output) before modeling (baseline) , just after modeling (t0) , and 2 h (t2) , 4 h (t4) , 6 h (t6) and 8 h (t8) after trearment. Needle biopsies of lung tissue were made before modeling and at t0 and t8 and prepared for microscopy observation after Hematoxylin- eosin staining method (HE staning). Repeated measurement data were compared among repeated measures by the ANOVA and the difference between groups was compared by one-wey ANOVA. Results (1) The HR and MAP of all animals increased obviously while the oxygenation index declined significantly at modeling just made (t0) compared to those before modeling (all P 0.05). (2) The ELWI and PVPI of all animals increased obviously at modeling just made (t0) compared to those before modeling (all P <0.05). The ELWI and PVPI were decreased after treatment. And at the same time, the ELWI and PVPI of A and B groups were significantly lower than those of C group after treatment (all P <0.05). (3) The alveolar tissue showed obviously injured changes at modeling just made (t0). The injury was relieved 8h after trearment, which was most markedly in group C. Conclusions With the combination of 6% hydroxyethyl starch 130/ 0.4 and furosemide administered, the acute lung injury induced by paraquat poisoning can be effectively relieved, promoting gas exchange, and improve oxygenation. Key words: Paraquat; Acute lung injury; 6% hydroxyethyl starch 130/ 0.4; Furosemide; Pulse indicates continuous cardiac output monitoring; Extravascular lung water index; Pulmonary vascular permeability index; Oxygenation index