Indomethacin Improvement of Septic Acute Respiratory Failure in a Porcine Model

The effects of indomethacin, a prostaglandin synthesis blocker, were tested in a porcine model of spetic acute respiratory failure (ARF) produced by continuous infusion of live Ps. aeruginosa. Control groups received either indomethacin boluses (2 mg/kg) intravenously at 20 and 210 minutes or Ps. aeruginosa infusion (2 x 10 CFU/20 kg/min). The treatment group received both continuous Ps. aeruginosa infusion and indomethacin. Indomethacin alone transiently but significantly decreased cardiac indices, heart rate, and PaCO2. With Ps. aeruginosa infusion, significant pulmonary hypertension, hypoxemia, increased intrapulmonary shunt fraction, and systemic hypotension occurred. In this porcine model of septic ARF, indomethacin doubled the survival period and improved cardiopulmonary parameters.