Peritoneal ventilation inrabbits: augmentation ofgasexchange withcisapride

Peritoneal ventilation has beenshowntobeeffective inachieving extrapulmonary oxygenation andcarbon dioxide elimination inananimalmodelof severe adult respiratory distress syndrome (ARDS).Cisapride isa"prokinetic" agent (increases gastric emptying), thatmayin- crease thesplanchnic circulation andthus favourably affect gasexchangeinperi- toneal ventilation. Methods-UsingDopplerultrasound the effect ofcisapride on theportal venous circulation wasexaminedineight spon- taneously breathing rabbits andtheeffect ofcisapride ongasexchange infive rabbits spontaneously breathing room airwas compared withthatofacontrol groupwho didnotreceive cisapride. Itseffect ongas exchange infiverabbits withARDS being treated withmechanical lungandperi- toneal ventilation wascomparedwiththat ofa control group,anditseffect ongas exchangein fiverabbitswithARDS treated withconventional ventilation was alsocompared withthatofacontrol group. Results - Enteral administration ofcisa- prideincreased portalvenousblood velocity, asmeasuredultrasonographically, byameanof188%onehourafter receiving thedrug.Inrabbits withARDS being treated withbothperitoneal ventilation andmechanical ventilation tothelungs, thosereceiving cisapride hadarterial oxy- gentensions 1-5-3timesthatofcontrols. Cisapride hadnoeffect onarterial blood gastensions inrabbits who werespon- taneously breathing room air,nor in rabbits withARDS who received only conventional mechanical lungventilation. Conclusions -Cisapride increases arterial oxygenation inrabbits withsevereARDS treated withperitoneal ventilation, prob- ablyduetoitsability toincrease splanch- niccirculation. Itshouldbeconsidered asan adjuvant medication toperitoneal ventilation.