On the other hand, because hypoxic pulmonary vasoconstriction is markedly impaired by lung and systemic inflammation [ 3], increase in venous mixed oxygen saturation (SvO2) may improve arterial oxygenation if pulmonary blood flow does not increase in non aerated lung regions.
Corticosteroids could also improve arterial stiffness [ 93].
Therefore, selective endothelin-A receptor antagonists could improve arterial stiffness.
These include improved blood pressure control, reduced fasting triglycerides, more rapid clearance of chylomicrons, increased high-density lipoprotein cholesterol, reduced total cholesterol to high-density lipoprotein cholesterol ratio, reduced atheroma (in experimental animals), and improved arterial compliance and flow mediated dilation (for review, see Din and coworkers [ 62]).
Inhaled nitric oxide (NO) reduces pulmonary hypertension in severe ARDS and improves arterial oxygenation by redistributing blood flow to areas with a normal ventilation/perfusion ratio [ 1].
Inhaled nitric oxide (INO) allows selective pulmonary vasodilation and improves arterial oxygenation by redistribution of blood flow towards better ventilated parenchyma [ 3].
Our hypothesis was that 0.5 FiO2 would reduce ventilation-perfusion mismatching and increase the fraction of pulmonary blood flow that is oxygenated, thus improving arterial oxygen content and DO2.
"The blood flow findings are obviously important for improving arterial graft construction," says Michael Bettmann, a cardiovascular specialist at Dartmouth-Hitchcock MeDartmouthter of Dartmouth in New Hampshire, "but they also may be relevant to evolving new techniques, primarily nonoperative ones for treating peripheral arterial diseases".
Therefore, it does not only reduce pulmonary hypertension but it also redistributes blood flow towards the ventilated areas, thereby reducing intrapulmonary shunt and improving arterial oxygenation [ 11].
In conclusion, we demonstrated that low-flow CO2 dialysis using a modified renal replacement system improved arterial pCO2 significantly, thereby optimizing pH.
