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Single dose blood toxicokinetics of methacrylonitrile in the F344 rat.

Methacrylonitrile (MAN) is a widely used industrial chemical. Minimal information is available on its effects or toxicokinetics; therefore, current investigations were undertaken as part of an overall effort to characterize MAN toxicity in laboratory animals. Groups of male F344 rats were administered MAN intravenously (29, 58, or 116 mg/kg) or perorally (58 mg/kg). Blood samples were collected at various time points after dosing and serum MAN concentrations were measured. Concentration versus time profiles were characterized by two phases and a two-compartment model was selected to fit the data. Toxicokinetic parameters were determined using Simusolv. The 39-min terminal half-life shows that 99% of an i.v. dose is eliminated in less than 5 hr, suggesting that the potential for MAN bioaccumulation is minimal. The volume of distribution at steady-state (747 ml/kg) indicates little distribution of MAN into tissues. Clearance is higher at 29 mg/kg than at the two other doses, suggesting that MAN elimination is saturable at doses above 29 mg/kg. MAN disposition is route-dependent. Approximately 36% of the i.v. dose was exhaled as unchanged MAN, while only 18% was eliminated via this route following po administration. MAN disposition data also suggest that a significant first-pass metabolism may occur because a higher percentage of metabolites was produced following oral vs i.v. administration. Perorally, 39% of the dose was exhaled as CO2 and 22% was excreted into the urine as metabolites over the 24-hr dosing interval. In comparison, following i.v. delivery, 26% of the dose was exhaled as CO2 and 16% was excreted into the urine as metabolites. About equal amounts of acetone were excreted following administration by either route. This information may prove useful in designing long-term toxicity studies for MAN by the National Toxicology Program and in interpreting the results of such studies.

Acetone↗

Vitamin A potentiation of carbon tetrachloride hepatotoxicity: enhanced lipid peroxidation without enhanced biotransformation.

To better understand the mechanism by which vitamin A (VA, retinol) potentiates the hepatotoxicity of carbon tetrachloride, its effect on metabolism and covalent binding of CCl4 as well as its effect on lipid peroxidation was determined. 14CCl4 (0.15 ml/kg, 21.4 microCi/mmol) was administered to male SD rats that had been treated with vitamin A (250,000 IU/kg/day for 1 week) or vehicle. Vitamin A pretreatment did not increase the 24-hr biotransformation of 14CCl4 to 14CO2, to exhaled volatile organics, or to metabolites excreted in the urine or feces. Furthermore, there was no dramatic effect of vitamin A pretreatment on the covalent binding of 14CCl4 equivalents to hepatic lipids and proteins at early time points (1/2-4 hr) after administration of 14CCl4. The microsomal concentration of cytochrome P450 was unchanged by vitamin A treatment. There was a dramatic increase (6-8x) in the amount of ethane exhaled in those rats treated with vitamin A and then administered CCl4 compared to that of those administered CCl4 without pretreatment. The enhanced lipid peroxidation as evidenced by the increased exhalation of ethane was not the result of vitamin A-induced decreases in hepatic glutathione or vitamin E. These data indicate that the potentiation of CCl4 hepatotoxicity by vitamin A pretreatment is associated with an enhancement of lipid peroxidation that is independent of changes in CCl4 biotransformation or the hepatic concentration of two important hepatoprotective agents.

Animals↗

Use of a physiologically based model to predict systemic uptake and respiratory elimination of perchloroethylene.

The pharmacokinetics of inhaled perchloroethylene (PCE) were studied in male Sprague-Dawley rats to characterize the pulmonary absorption and elimination of the volatile organic chemical (VOC). The direct measurements of the time course of PCE in the blood and breath were used to evaluate the ability of a physiologically based pharmacokinetic (PBPK) model to predict systemic uptake and elimination of PCE. Fifty or 500 ppm PCE was inhaled for 2 hr through a miniaturized one-way breathing valve by unanesthetized male Sprague-Dawley rats of 325-375 g. Serial samples of the inhaled and exhaled breath streams, as well as arterial blood, were collected during and following PCE inhalation and analyzed by headspace gas chromatography. PCE-exhaled breath concentrations increased rapidly to near steady state (i.e., within 20 min) and were directly proportional to the inhaled concentration. Uptake of PCE into the blood was also rapid, but blood levels continued to increase progressively over the course of the 2-hr exposure at both exposure levels. Cumulative uptake, or total absorbed dose, was not proportional to the exposure level. A PBPK model was developed from in vivo parameters determined from tissue concentration-time data in a companion ia study (Dallas et al., 1994, Toxicol. Appl. Pharmacol. 128, 50-59). PCE concentrations in the blood and exhaled breath during and following PCE inhalation were well predicted by the PBPK model. Despite species differences in blood:air and lung:air partition coefficients, the model was used to account for similar levels of PCE and other VOCs in the expired air of rats and humans. The model also accurately simulated percentage uptake and cumulative uptake of PCE over time. The model's ability to predict systemically absorbed doses of PCE under a variety of exposure scenarios should be useful in assessment of risks in occupational and environmental settings.

Absorption↗

Experimental exposure to methyl tertiary-butyl ether. I. Toxicokinetics in humans.

Methyl tertiary-butyl ether (MTBE) is widely used in gasoline as an oxygenate and octane enhancer. The aim of this study was to evaluate the uptake, distribution, metabolism, and elimination of MTBE in humans. Ten healthy male volunteers were exposed to MTBE vapor (5, 25, and 50 ppm) on three different occasions during 2 h of light physical exercise (50 W). MTBE and the metabolite tertiary-butyl alcohol (TBA) were monitored in exhaled air, blood, and urine. Blood and urine were collected at selected time intervals, during and up to 3 days after the exposure, and analyzed by head space gas chromatography. MTBE in exhaled air was collected with sorbent sample tubes and subsequently analyzed by gas chromatography. The respiratory uptake of MTBE was rather low (42-49%), and the respiratory exhalation was high (32-47%). A relatively low metabolic blood clearance (0.34-0.52 L/h/kg) was seen compared to many other solvents. The kinetic profile of MTBE in blood could be described by four phases, and the average half-lives were 1 min, 10 min, 1.5 h, and 19 h. The post-exposure decay curve of MTBE in urine was separated into two linear phases, with average half-lives of 20 min and 3 h. The average post-exposure half-lives of TBA in blood and urine were 10 and 8.2 h, respectively. The urinary excretion of MTBE and TBA was less than 1% of the absorbed dose, indicating further metabolism of TBA, other routes of metabolism, or excretion. The kinetics of MTBE and TBA were linear up to the highest exposure level of 50 ppm. We suggest that TBA in blood or urine is a more appropriate biological exposure marker for MTBE than the parent ether itself.

Adult↗

A human physiologically based pharmacokinetic model for trichloroethylene and its metabolites, trichloroacetic acid and free trichloroethanol.

Nine male and eight female healthy volunteers were exposed to 50 or 100 ppm trichloroethylene vapors for 4 h. Blood, urine, and exhaled breath samples were collected for development of a physiologically based pharmacokinetic (PBPK) model for trichloroethylene and its two major P450-mediated metabolites, trichloroacetic acid and free trichloroethanol. Blood and urine were analyzed for trichloroethylene, chloral hydrate, free trichloroethanol and trichloroethanol glucuronide, and trichloroacetic acid. Plasma was analyzed for dichloroacetic acid. Trichloroethylene was also measured in exhaled breath samples. Trichloroethylene, free trichloroethanol, and trichloroacetic acid were found in blood samples of all volunteers and only trace amounts of dichloroacetic acid (4-12 ppb) were found in plasma samples from a few volunteers. Trichloroethanol glucuronide and trichloroacetic acid were found in urine of all volunteers. No chloral hydrate was detected in the volunteers. Gender-specific PBPK models were developed with fitted urinary rate constant values for each individual trichloroethylene exposure to describe urinary excretion of trichloroethanol glucuronide and trichloroacetic acid. Individual urinary excretion rate constants were necessary to account for the variability in the measured cumulative amount of metabolites excreted in the urine. However, the average amount of trichloroacetic acid and trichloroethanol glucuronide excreted in urine for each gender was predicted using mean urinary excretion rate constant values for each sex. A four-compartment physiological flow model was used for the metabolites (lung, liver, kidney, and body) and a six-compartment physiological flow model was used for trichloroethylene (lung, liver, kidney, fat, and slowly and rapidly perfused tissues). Metabolic capacity (Vmaxc) for oxidation of trichloroethylene was estimated to be 4 mg/kg/h in males and 5 mg/kg/h in females. Metabolized trichloroethylene was assumed to be converted to either free trichloroethanol (90%) or trichloroacetic acid (10%). Free trichloroethanol was glucuronidated forming trichloroethanol glucuronide or converted to trichloroacetic acid via back conversion of trichloroethanol to chloral (trichloroacetaldehyde). Trichloroethanol glucuronide and trichloroacetic acid were then excreted in urine. Gender-related pharmacokinetic differences in the uptake and metabolism of trichloroethylene were minor, but apparent. In general, the PBPK models for the male and female volunteers provided adequate predictions of the uptake of trichloroethylene and distribution of trichloroethylene and its metabolites, trichloroacetic acid and free trichloroethanol. The PBPK models for males and females consistently overpredicted exhaled breath concentrations of trichloroethylene immediately following the TCE exposure for a 2- to 4-h period. Further research is needed to better understand the biological determinants responsible for the observed variability in urinary excretion of trichloroethanol glucuronide and trichloroacetic acid and the metabolic pathway resulting in formation of dichloroacetic acid.

Administration, Inhalation↗

Reactive oxygen species in the progression of CCl4-induced liver injury.

Pretreatment of rats with large doses of vitamin A (retinol) dramatically increased the hepatotoxicity of carbon tetrachloride (CCl4). Experiments were performed to elucidate the mechanism of this potentiation. Hypervitaminosis A was produced by oral administration of retinol, 250,000 IU/kg for seven days. CCl4 was then administered at a dose of 0.15 ml/kg, ip. This large dose of vitamin A did not enhance the biotransformation of CCl4, but did produce a 4-fold increase in CCl4-induced lipid peroxidation, as assessed by ethane exhalation. Because vitamin A has been shown to activate macrophages, it was hypothesized that this increased lipid peroxidation and liver injury resulted from the release of reactive oxygen species from activated Kupffer cells. By using a chemiluminescence assay, an enhanced release of free radicals was detected in Kupffer cells isolated from vitamin A pretreated rats. In addition, Kupffer cells from vitamin A pretreated rats displayed enhanced phagocytic activity in vitro, towards sheep red blood cells. In vivo, vitamin A pretreated rats cleared carbon particles from the blood 2-3 times faster than non-pretreated rats. In vivo administration of superoxide dismutase (SOD) 2 hr after CCl4 exposure did not influence CCl4 toxicity in control rats but did block the enhanced ethane exhalation and also the potentiation of CCl4 liver injury in vitamin A treated rats. Administration of methyl palmitate, an inhibitor of Kupffer cell function, did not inhibit CCl4 toxicity in control rats, but did effectively block enhanced ethane exhalation and potentiation of CCl4 injury in vitamin A treated rats. We conclude that potentiation of CCl4 hepatotoxicity by hypervitaminosis A is mediated in part by reactive oxygen species released from activated Kupffer cells.

Animals↗

Relationships between the pharmacokinetics of carbon tetrachloride conversion to carbon dioxide and chloroform and liver injury.

Rate and extent of CCl4 metabolism by pathways leading to CO2 and CHCl3 were evaluated by measuring the amounts of these metabolites exhaled during discrete intervals following six different doses of CCl4. Pulmonary pharmacokinetics of 14CO2 and CHCl3 exhalation after CCl4 administration were compared with those after Na214CO3 and 14CHCl3 administration. Exhalation of 14CO2 metabolite declined more rapidly than expected after hepatotoxic doses of CCl4. This decline could be due to injury associated changes in the metabolism of CCl4.

Animals↗

Metabolic fate of chlorinated paraffins: degree of chlorination of [1-14C]-chlorododecanes in relation to degradation and excretion in mice.

The disposition of three [1-14C]-chlorododecanes (MCDD, PCDD I and PCDD II; 17.4%, 55.9%, and 68.5% chlorination) was studied in C57Bl mice. [1-14C]-lauric acid (LA) was studied as reference compound. Fifty-two percent (MCDD), 32% (PCDD I), and 8% (PCDD II) of the radioactive doses were exhaled as 14CO2 during 12 h after i.v. injection. Similar results were obtained after p.o. administration. In addition to a marked labelling of the liver and fat, the distribution patterns observed at 24 h after administration revealed an uptake of radioactivity in tissues with high cell turnover/high metabolic activity, e.g., intestinal mucosa, bone marrow, salivary glands and thymus. The concentration of radioactivity in these sites and the exhalation of 14CO2, which were inverse to the degree of chlorination, indicate that the chloroalkanes are degraded to metabolites which can be utilized in the intermediary metabolism. A similar, although more pronounced, distribution pattern and 14CO-2-exhalation (70% of i.v. dose) was observed after LA administration. The long time retention of heptane-soluble radioactivity in liver and fat (indicating unmetabolized substance) increased with degree of chlorination. On the contrary, the administration of LA and the chlorododecanes MCDD and PCDD I, but not of PCDD II, resulted in a selective labelling of the central nervous system 30-60 days after injection.

Adipose Tissue↗

Retention of styrene following controlled exposure to constant and fluctuating air concentrations.

An experiment was designed to determine whether the respiratory retention of styrene vapor, as estimated from measurements of end-exhaled air, was the same during periods of both constant and fluctuating exposure. Six human subjects were exposed to styrene inside a experimental chamber. A computer-controlled system was used to generate time-varying air concentrations of styrene over 4-5h in both multistep sequences of constant exposure (four subjects exposed to 15-99 ppm of styrene in 100-min steps) and fluctuating patterns representative of occupational exposures (two subjects exposed to mean concentrations of styrene of 50 ppm). In the latter case, lognormally distributed exposures, which fit one of two first-order autoregressive models, were generated at intervals of 2.5 min. It was found that the concentration of styrene in end-exhaled air was reduced by about half if the subject inhaled one to three breaths of clean air prior to sampling. This suggests that significant amounts of styrene were desorbed from the lining of the lungs during the initial exhalation. The retention of styrene vapor during constant exposures was 0.935 and was independent of the level. During each of the two sets of fluctuating exposure the retention of styrene was also constant and was independent of both the variance and autocorrelation coefficient. However, the retention of styrene during the fluctuating exposure (estimates ranged from 0.957 to 0.973) was significantly higher than that observed during the constant exposures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Hybrid information provided by the 14C-aminopyrine breath test. Studies with 14C-monomethylaminoantipyrine in the guinea pig.

N-Demethylation of 14C-aminopyrine (14C-AP), labelled at the methyl groups of the tertiary amino group, yields H14 CHO and 14C-monomethylaminoantipyrine (14C-MMAAP) which also undergoes N-demethylation, however, at a slower rate as measured in hepatic microsomes. As after intraperitoneal application to male guinea pigs of 14C-AP (75 mg/kg; 50 muCi/kg), exhalation rate of 14CO2 declines in a biphasic manner, the hypothesis was tested whether the terminal part might reflect N-demethylation of MMAAP. The application of 14C-MMAAP (70 mg/kg; 10 muCi/kg), resulted in monophasic curves of 14CO2 exhalation rate. Their half lives were, however, longer than terminal half lives obtained after 14CAP. Obviously, this terminal phase does not represent 14CO2 formation from the metabolite MMAAP only, but 14C-AP might still contribute to 14CO2 production. Confirmation was obtained by HPLC determination of AP and MMAAP in serum after injection of AP. Shortly after injection, high concentrations of AP and low ones of MMAAP were found in blood from the portal vein and systemic circulation. Thus, initial parts of 14CO2-exhalation rate curves reflect predominantly AP metabolism whereas later phases provided hybrid information.

Aminopyrine↗

Assessment of drug metabolism in hepatic disease: comparison of plasma kinetics of oral cyclobarbital and the intravenous aminopyrine breath test.

The exhalation of 14CO2 derived from an i.v. tracer dose of [dimethylamine-14-C]aminopyrine has been investigated in normal controls and patients. They subsequently ingested 200 mg cyclobarbital calcium in the evening and the decline in the plasma drug level over the following 2 days was measured by thin-layer chromatography. The peak specific activity of exhaled 14CO2 occurred 0.5-2 h after 14C-aminopyrine injection in the absence of liver disease and in non-cirrhotic liver disorders. It was delayed in certain patients with cirrhosis. Compared to 8 medically healthy subjects, 10 patients with acute viral hepatitis, 8 with cirrhosis and 10 with fatty liver exhibited a significantly increased half-life of 14CO2 exhalation. Normal mean values were found in 12 patients with non-cirrhotic alcoholic liver disease and in 14 patients with non-hepatic diseases. The cyclobarbital (CB) half-life was prolonged and the clearance reduced in patients with viral hepatitis, cirrhosis or alcoholic liver damage as compared to data from 17 control subjects. Due to a larger apparent volume of distribution, patients with fatty liver disease had an increased CB half-life, although its clearance was normal. A close negative correlation was detected between the clearance and the logarithm of the CB level measured 36 h after drug ingestion. The oral CB test evaluated from a single blood sample taken about 36 h after drug administration appears to be a useful indicator of human drug metabolising capacity. Discrimination between patients with and without disordered liver function was similar in the two drug elimination tests.

Adolescent↗

Arousal reduction with biofeedback-supported respiratory meditation.

This study investigated the effectiveness of a relaxation procedure that combines a concentration aid, in the form of biofeedback, with elements of approved relaxation procedures. Ten subjects completed two sessions, one with and one without feedback. Half of the subjects started with the feedback session and then completed the session without feedback; the other half had the reverse order. In the experimental procedure, subjects had to concentrate on their exhalation, being supported by respiratory feedback. In the background they heard slow movements of baroque music and relaxation-suggesting sentences. The control procedure contained only background music and relaxation-suggesting sentences. Both procedures elicited a trophotropic response: Finger temperature increased while skin conductance level, number of skin conductance responses, and muscle tension decreased. However, with respiratory feedback and meditation, there was an additional, specific effect, a decrease in respiration and heart rate, to an extent not found in the control procedure. It is suggested that exhalation feedback helps to concentrate on the exhalation process and by this means slows respiration rate, and as a consequence, also heart rate. Therefore, respiratory feedback could be a useful tool for inducing relaxation and slowing of heart rate.

Adult↗

Characteristics of haloethylene-induced acetonemia in rats.

A series of halogenated ethylenes (vinyl chloride, vinylidene fluoride, cis- and trans-1,2-dichloroethylene, perchloroethylene) induces increased acetone exhalation in rats. Exposures of differently pre-treated rats to vinylidene fluoride suggest that a metabolite of the haloethylene must be envolved in eliciting this formation of acetone. This conclusion is based on (a)dependence of acetone exhalation on the concentration of vinylidene fluoride, (b)effect of inducing agents, (c)effect of pyrazol, a metabolic inhibitor, (d)effect of cysteine, (e)effect of hypoxia and (f)the time course of acetone exhalation.

Acetone↗

On-line computer estimation of carbon dioxide response curves.

Anesthesiologists are concerned with the effect of various anesthetics on a patient's central nervous ventilatory control. The most widely accepted method of determining the effect of a drug is to compare carbon dioxide response curves (delta VE/delta PETCO2, where VE = minute ventilation [in L/min] and PETCO2 = end-tidal carbon dioxide [in mm Hg]) measured before and after administration of the drug. Additional information concerning neuromechanical control can be obtained by also including a measure of the airway occlusion pressure (generally measured 100 ms after occlusion, i.e., P100). To facilitate these measurements we have developed a portable, computer-controlled data acquisition system. It includes an Apple II+ computer and measures VE, PETCO2, and P100. Each subject rebreathes exhaled carbon dioxide through a two-way breathing valve attached to a 9-liter reservoir, which is initially filled with 5% carbon dioxide and balance oxygen. Exhaled carbon dioxide concentrations are measured with an infrared medical gas analyzer on samples taken through a catheter connected at the mouthpiece. The exhaled flow is measured with a pneumotachograph in conjunction with a differential pressure transducer, and P100 is determined with a Validyne MP45 pressure transducer.

Airway Resistance↗

The effects of therapist breathing style on subject's inhalation volumes.

This study explored how the clinicians'/experimenters' breath patterns affected subjects' inhalation volume. 20 volunteer subjects inhaled 20 sequential breaths (10 normal and 10 paced) with their eyes closed. During the paced exhalation, the experimenter audibly exhaled in phase with the subjects' exhalation. The subjects's inhalation volumes significantly increased during the paced as compared to the initial normal breathing phase, F(1,19) = 8.82, p < .01, repeated measures ANOVA. These findings confirm that the clinician's breathing style directly affects the client's breath pattern.

Awareness↗

Effect of Acarbose on the production of hydrogen and methane and on hormonal parameters in young adults under standardized low-fibre mixed diets.

Short and middle term effects of Acarbose were studied in volunteers on a standardized, low-fibre, mixed diet for the development of tolerance phenomena with gas exhalations and some peptide hormone levels as main parameters. Both hydrogen and methane were measured quantitatively as diurnal profiles. Acarbose caused an about 20-fold increase of H2 exhalation and had only moderate effects on methane production, indicating the presence of fermentable carbohydrates in the large bowel. Methanogenic individuals exhaled significantly less H2 than did non-methanogenic subjects. Changes in blood glucose, serum insulin, GIP, gastrin, and plasma glucagon, caused by Acarbose, reflected delayed glucose absorption and were plausible within the regulatory framework of carbohydrate assimilation. When the Acarbose regime was maintained for 5 weeks on a controlled diet, abdominal sensations like e.g. meteorism declined remarkably while carbohydrate fermentation remained high and lowered GIP was sustained. Thus functional responses of the gastro-intestinal tract to altered carbohydrate supplies, elicited by Acarbose, were found by 3 independent parameters: anaerobic gas production, peptide hormone levels, and subjective abdominal sensations. The objective parameters seem to remain constant in the longer run, while subjective parameters show long-term adaptation.

Acarbose↗

A clinical assessment of desflurane anaesthesia and comparison with isoflurane.

In 48 randomly assigned ASA I adult patients undergoing elective orthopaedic procedures, we compared the pharmacodynamics of desflurane (DF) and isoflurane (IF), and their pharmacokinetics during rapid induction of deep anaesthesia (via face mask, to 1.5-2 MAC, after thiopentone), maintenance of anaesthesia at 1.25 MAC, and emergence therefrom. During induction, laryngeal reactions ranging from mild crowing to laryngospasm occurred more frequently with DF than with IF (15/24 DF, 5/24 IF; P < 0.05) and was more severe (9/24 DF, 1/24 IF, excluding the mildest form, P < 0.05). As a result, induction of anaesthesia was not accomplished faster with DF, in spite of a faster equilibration between exhaled and inhaled concentrations. Emergence from DF was more rapid and less complicated by delirium. Pharmacokinetically, the exhaled concentration of DF reached 90% of the inhaled concentration within five minutes of induction, whereas that of IF lagged behind and remained 25% below the inhaled concentration (1 vs 1.34 +/- 0.05) even one hour after induction. Premature ventricular contractions did not occur in any patient even during periods of difficulty with the airway and oxygen desaturation. It is concluded that DF is a safe anaesthetic, pharmacokinetically superior to IF but clinically inferior for induction of anaesthesia via a face mask. Because of the fast equilibration, the exhaled concentration of DF can be controlled more precisely by the dial setting of the vaporiser.

Adolescent↗

Nitric oxide contamination of hospital compressed air improves gas exchange in patients with acute lung injury.

OBJECTIVE: We tested the hypothesis that NO contamination of hospital compressed air also improves PaO(2) in patients with acute lung injury (ALI) and following lung transplant (LTx). DESIGN: Prospective clinical study. SETTING: Cardiothoracic intensive care unit. PATIENTS: Subjects following cardiac surgery (CABG, n=7); with ALI (n=7), and following LTx (n=5). INTERVENTIONS: Four sequential 15-min steps at a constant FiO(2) were used: hospital compressed air-O(2) (H1), N(2)-O(2) (A1), repeat compressed air-O(2) (H2), and repeat N(2)-O(2) (A2). MEASUREMENTS AND RESULTS: NO levels were measured from the endotracheal tube. Cardiorespiratory values included PaO(2) were measured at the end of each step. FiO(2) was 0.46+/-0.05, 0.53+/-0.15, and 0.47+/-0.06 (mean+/-SD) for three groups, respectively. Inhaled NO levels during H1 varied among subjects (30-550 ppb, 27-300 ppb, and 5-220 ppb, respectively). Exhaled NO levels were not detected in 4/7 of CABG (0-300 ppb), 3/6 of ALI (0-140 ppb), and 3/5 of LTx (0-59 ppb) patients during H1, whereas during A1 all but one patient in ALI and three CABG patients had measurable exhaled NO levels (P<0.05). Small but significant decreases in PaO(2) occurred for all groups from H1 to A1 and H2 to A2 (132-99 Torr and 128-120 Torr, P <0.01, respectively). There was no correlation between inhaled NO during H1 and exhaled NO during A1 or the change in PaO(2) from H1 to A1. CONCLUSIONS: Low-level NO contamination improves PaO(2) in patients with ALI and following LTx.

Air↗