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Atalay C, Dogan N, Aykan S, Gundogdu C, Keles MS
Correspondence: Dr Canan Atalay, firstname.lastname@example.org
Introduction This study aimed to test the feasibility of spironolactone treatment in comparison with a surfactant in the early stage of acute respiratory distress syndrome (ARDS) in rats, as assessed by the acute lung injury (ALI) score, blood gas, brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP).
Methods A total of 40 rats were randomly allocated into one of five groups (n is eight). The baseline group (Group B) was subjected to neither tracheotomy nor ARDS induction, while the sham group (Group N) was subjected to tracheotomy upon ARDS induction by acid aspiration. The other three groups were administered either a single dose of spironolactone (100 mg/kg, Group Sp) or surfactant (100 mg/kg, Group S), or were untreated (Group A). Blood samples were collected from the femoral artery for blood gases, BNP and NT-proBNP measurements.
Results ARDS induction decreased the blood PO2 /FiO2 ratio and increased the BNP and NT-proBNP levels (p is less than 0.001). Compared with the ARDS-untreated group, spironolactone treatment was more effective at reducing the elevated BNP (72 percent versus 37 percent) and NT-proBNP (53 percent versus 23 percent) levels and ALI score (28 percent versus 7 percent) than surfactant treatment. Moreover, the blood PO2/FiO2 ratio was negatively correlated with the BNP (r is -0.79), NT-proBNP (r is -0.85) and ALI scores (r is -0.85).
Conclusion Spironolactone is an effective form of treatment for ARDS at an early stage, as reflected by an increased blood O2/FiO2 ratio, decreased BNP and NT-proBNP levels, and ALI score.
Keywords: acute lung injury, acute respiratory distress syndrome, blood gas, brain natriuretic peptide, spironolactone, surfactant
Singapore Med J 2010; 51(6): 501-505