Table 1 Animal studies assessing possible therapeutic interventions for neurogenic pulmonary edema (NPE)
Intervention | Animal model | Study design/results |
|---|---|---|
Alpha Blockade | Â | Â |
Phentolamine (1 mg/kg) | Rats | Prevented pulmonary edema after induced injury to anterior hypothalamus [23] |
Phenoxybenzamine (3 mg/kg) | Dogs | Prevented pulmonary artery and systemic pressure increase after CSF pressure was increased from 100 to 200 mmHg [22] |
Phenoxybenzamine (1.5 mg/kg) | Dogs | Prevented increases in pulmonary perfusion pressure and PVR and associated increases in lung water, Qs/Qt, VD, and hypoxemia induced by ICP elevation [50] |
Phentolamine (2 mg/kg) | Sheep | Prevented the expected increase in permeability and lymph flow after CNS insult [38] |
Beta Blockade | Â | Â |
Propranolol (0.5 mg/kg) | Dogs | Pulmonary artery and systemic pressure unchanged with use of beta blocker after CSF pressure was increased from 100 to 200 mmHg [22] |
Propranolol (1.5 mg/kg) | Dogs | Pretreatment with beta blocker attenuated the increase in PVR during elevation in ICP but did not prevent increases in lung water, Qs/Qt, VD, and hypoxemia [50] |
Sympathetic Outflow Denervation | Â | Â |
Bilateral thoracic sympathectomy | Dogs & Rabbits | Sympathectomy prior to induced CNS insult did not prevent pulmonary pressure elevation [35] |
Spinal cord transection | Monkeys | NPE prevented by sympathetic denervation [18] |
Cholinergic Influence | Â | Â |
Vagotomy | Dogs & Rabbits | Vagotomy did not prevent increases in pulmonary vascular pressures [35] |
Vagotomy | Monkeys | Vagotomy did not prevent NPE [18] |
Other | Â | Â |
Methylprednisone (40 mg/kg) | Rats | Prevented aconitine induced NPE and systemic HTN [51] |
Hypovolemia | Rats | Lowering pulmonary blood volume by phlebotomy prevented aconitine induced NPE [51] |
Naloxone | Sheep | Induced NPE could be prevented by opiate antagonism, suggesting a role for endorphins [45] |