TY - JOUR T1 - Neurogenic pulmonary edema: Effect of corticosteroids JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2015.PA1797 VL - 46 IS - suppl 59 SP - PA1797 AU - Asmae Belhaj AU - Laurence Dewachter AU - CĂ©line Dewachter AU - Myriam Remmelink AU - Sandrine Rorive AU - Robert Naeije AU - Benoit Rondelet Y1 - 2015/09/01 UR - http://erj.ersjournals.com/content/46/suppl_59/PA1797.abstract N2 - Introduction: In lung transplantation, neurogenic pulmonary edema (NPE) is a major impediment to lung harvesting.Corticosteroids may mitigate pulmonary edema but the role of inflammation in the pathogenesis of the condition remains uncertain.In a model of brain death (BD), we studied the role of inflammation in the NPE pathobiology.Methods & results: Sixteen pigs were randomized to placebo (n=9) or corticosteroids (n=7) 1.5 mg/kg before BD induced by slow intracranial blood infusion.Four hours after BD, the animals underwent a hemodynamic evaluation followed by lung tissue sampling for rtq-PCR for HO-1 and the pro-inflammatory ratio IL-6 / IL10, and lung histopathologic injury score. A control group (n=9) was studied.BD increased pulmonary pressure (PAP), pulmonary vascular resistance (PVR), capillary pressure (Pcap), pulmonary arterial impedance at 0Hz (Z0), and pulmonary arterial elastance (Ea). Systemic arterial pressure (SAP) was decreased while occluded pulmonary arterial pressure, right auricular pressure and characteristic impedance did not change. The ratio of partial pressure arterial oxygen and fraction of inspired oxygen (Pa02/Fi02) collapsed. BD was associated with an increase in IL-6/IL-10 and a decrease in HO-1 gene expression. The injury score was increased in BD group.Corticosteroids therapy totally prevented changes in PAP, PVR, Pcap, Z0, Ea, and IL6/IL10 and HO-1 gene expression in lung tissue. Changes in Pa02/iF02 and injury score were partially prevented.Conclusions: BD is responsible for neurogenic pulmonary edema.Corticosteroids prevent hemodynamics and partially prevent biological changes in neurogenic pulmonary edema. ER -