Efficacy of Inhaled Nitric Oxide under VV-ECMO for ARDS

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K16525
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55040:Respiratory surgery-related
• Research Institution: Jikei University School of Medicine
• Principal Investigator: Mori Shohei 東京慈恵会医科大学, 医学部, 講師 (30648100)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 一酸化窒素吸入 / ARDS / VV-ECMO

Outline of Final Research Achievements

The treatment model combining the VV-ECMO with NO inhalation therapy could be constructed without problems, and one of the aims of this study, the development of a preclinical model in rats, was achieved. In addition, a comparison of circulatory dynamics showed that blood pressure was maintained after the start of VV-ECMO in the VV-ECMO with NO inhalation group compared to the VV-ECMO group, suggesting that the reduction of right heart load by NO inhalation may have contributed to the maintenance of blood pressure during VV-ECMO. NO inhalation induced a decrease in some inflammatory cytokines (CXCL3_GRO gamma_. CINC-2, IL-1 alpha_IL-1F1, L-Selectin_CD62L), and no differences were observed in group comparisons under VV-ECMO, but NO inhalation therapy was found to reduce serum inflammatory cytokines in the rat ARDS model.

Free Research Field

呼吸器外科

Academic Significance and Societal Importance of the Research Achievements

VV-ECMO体外循環回路にNO吸入療法を併用する治療モデルは問題なく構築可能であり、ラットでのプレクリニカルモデルの開発を達成できた。今後、条件を変えてARDSに対するNO吸入効果を検証する動物実験モデルになりうる。VV-ECMOだけではなく体外式CO2除去治療との併用やNO濃度を増減させた治療効果の検証なども期待される。また本研究で得られた結果からはNO吸入が、血清中炎症性サイトカイン低下させる効果がある可能性や、VV-ECMO開始後の循環動態維持に寄与する可能性がある。