两种肝素联合在血液透析合并血液灌流治疗中的抗凝效果观察

目的:探讨普通肝素与低分子肝素联合在血液透析合并血液灌流中的抗凝效果。方法:将2013年1~12月血液透析合并血液灌流的患者16例共透析213例次,随机分为2组,A组106例次,B组107例次。A组患者抗凝剂的用量是根据体重给低分子肝素纳60~80μ/kg治疗开始前5 min静脉注射,最大量不超过5000 U,以后不再追加;B组患者抗凝剂的用量是在A组的基础上给普通肝素8 mg/h泵入,治疗结束后停止追加。结果:A组透析器与灌流器凝血情况高于B组,P0.05,有统计学意义。结论:将普通肝素与低分子肝素联合用于血液透析合并血液灌流治疗,并根据患者体重具体量化抗凝剂,能减少透析器与灌流器的凝血。     

护理干预在预防血液灌流联合血液透析凝血中的应用

目的探讨护理干预对降低血液灌流联合血液透析治疗时发生凝血的临床效果。方法对2013年3月~2013年12月40例血液透析联合血液灌流患者进行自身前后对照,观察护理干预前后血液灌流联合血液透析治疗时的凝血发生情况。结果常规操作组卸灌后有4例发生透析器和管路Ⅲ级凝血,更换透析器及管路继续治疗;5例透析器Ⅱ级凝血,静脉除泡器有絮状物阻塞透析回血,更换透析器管路继续治疗,1例透析器Ⅰ级凝血,静脉除泡器有絮状物。实验组1例Ⅰ级凝血,只有静脉除泡器有絮状物。干预后,凝血发生率显著降低,差异有统计学意义(P0.05)。结论采用一次性透析器、控制患者的超滤率、调整肝素用量及每1h用生理盐水100ml快速冲洗透析器、管路及静脉壶的干预方法,能有效达到治疗效果,避免凝血现象的发生,有效减少出血的危险,取得满意的效果,值得临床推广。     

血液灌流联合血液透析对尿毒症皮肤瘙痒症的观察与护理

【】目的 探讨血液灌流联合血液透析对尿毒症皮肤瘙痒症的治疗效果和护理。方法 对15例尿毒症皮肤瘙痒患者进行血液灌流联合血液透析治疗,血流量180—260ml/min,透析液流量500ml/min,肝素用量首剂16—20mg,追加5—6mg/h,或低分子肝素4000—5000U。联合治疗2h结束灌流,取下灌流器再继续血液透析2—3h,HD+HP1次/2周。结果 血液灌流联合血液透析治疗后多数患者皮肤瘙痒症状减轻,睡眠改善,自主感觉良好。结论 血液灌流联合血液透析对患者的皮肤瘙痒症状疗效显著。     

维持性血液透析患者血液灌流凝血的危险因素分析

目的 了解维持性血液透析患者血液灌流凝血的发生情况,分析其危险因素.方法 对我院血液净化中心行血液灌流治疗的72例维持性血液透析患者进行回顾性研究,收集患者临床资料和生化指标,分析维持性血液透析患者血液灌流凝血的发生率及其危险因素.结果 72例维持性血液透析患者共进行血液灌流302例次,7例患者发生血液灌流凝血16例次,其中Ⅱ级凝血6例次,Ⅲ级凝血10例次.发生过血液灌流凝血的患者合并肿瘤、糖尿病、血管通路功能不良比例及血清低密度脂蛋白、脂蛋白a水平明显高于未发生过血液灌流凝血者,两组患者在年龄、性别、透析龄、超滤速度、机器温度、跨膜压、血肌酐、尿素氮、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、脂蛋白a、血红蛋白、血小板及透析前APTT活化部分凝血酶活酶时间等方面相比,差异无统计学意义（P＞0.05）.凝血发生早期透析器呈现静脉压过低报警,凝血常发生在血液灌流1.5～2 h.结论 维持性血液透析患者常规行血液灌流治疗时存在凝血的风险.血液灌流联合血液透析过程中透析器呈现静脉压过低报警时应警惕凝血发生.合并肿瘤、糖尿病、血管功能不良比例及血清低密度脂蛋白、脂蛋白a水平增高的维持性血液透析患者联合血液灌流治疗时易发生凝血.     

不同预冲方法对血液灌流联合血液透析患者凝血和出血的影响

目的探讨两种不同预冲方法对血液灌流联合血液透析患者凝血和出血的影响。方法采用完全随机对照研究设计,将2012年1月至2013年12月在四川大学华西医院血液透析中心行血液灌流联合血液透析治疗的256例患者随机分为两组,干预组采用生理盐水冲洗肝素密闭式循环(128例),对照组采用不同浓度肝素生理盐水缓慢冲洗(128例),统计两种方法的预冲时间、生理盐水及肝素成本,比较两种预冲方法对灌流器、透析器凝血率和患者出血率的影响。结果 (1)干预组的预冲时间为每次(33.6±2.5)min,生理盐水及肝素成本分别为17.6元/次和7.6元/次;对照组的预冲时间为每次(45.6±3.2)min,生理盐水及肝素成本分别为34.4元/次和15.2元/次,两组的预冲时间、生理盐水及肝素成本比较差异均有统计学意义(P0.05)。(2)干预组血液灌流器凝血率为2.3%,血液透析器凝血率为3.9%;对照组血液灌流器和血液透析器的凝血率分别为3.9%、7.0%,两组灌流器、透析器凝血率比较差异有统计学意义(P0.05)。(3)干预组患者出血率为3.9%,对照组患者出血率为14.8%,两组患者出血率比较差异有统计学意义(P0.05)。结论采用生理盐水预冲肝素密闭式循环,可明显降低血液灌流联合血液透析患者的凝血率和出血率,节省护士操作时间、节约成本,值得临床进一步推广与验证。     

不同连接管路对血液灌流串联血液透析卸灌后透析器及管路凝血影响的研究

[目的]探讨血液灌流(HP)串联血液透析(HD)时应用不同连接管路连接血液灌流器和透析器,观察灌流结束卸灌后对透析器及血液管路凝血的影响。[方法]选择10例血液灌流串联血液透析病人,采用自身对照法。先用肝素生理盐水冲洗浸泡灌流器,使灌流器中吸附剂充分膨胀肝素化,达到最大吸附面积。灌流器串联于透析器前端,联合治疗2.5h,卸下灌流器再继续透析1.5h。每人10次共100例次,HP串联HD时采用常规管路连接,每人10次共100例次HP串联HD连接管路为带滤网管路连接法。观察透析治疗结束后透析器及管路的凝血情况。[结果]HP串联HD连接管路为带滤网管路卸灌后1例病人的透析器及管路有凝血现象发生,而常规管路生理盐水回血法卸灌后有9例病人的透析器及管路有不同程度的凝血现象发生。[结论]HP串联HD连接管路为带滤网管路连接法优于常规管路连接法。     

低分子肝素抗凝在血液灌流治疗中的应用

目的 观察低分子肝素作为抗凝剂在血液灌流治疗中的有效性及安全性.方法 选择我院2011年1月-12月行血液灌流治疗的180例,按性别、病种分层随机分为应用低分子肝素治疗的低分子肝素组及应用普通肝素治疗的普通肝素组,每组各90例.观察并比较两组的管路凝血、出血情况及血小板计数、部分凝血活酶时间(APTT).结果 低分子肝素组均未发生灌流器凝血,穿刺点无明显出血;普通肝素组有7例(7.8％)出现凝血,11例(12.2％)发生出血,其中8例渗血,3例流血.两组管路凝血及穿刺点出血发生率比较,差异均有统计学意义(P＜0.05).与治疗前比较,血液灌流治疗后低分子肝素组血小板、APTT均无明显变化(P＞0.05),普通肝素组血小板减少(P＜0.05),APTT明显延长(P＜0.05).结论 低分子肝素作为抗凝剂较普通肝素具有更好的抗凝效果,且能有效降低出血发生率,可在血液灌流治疗中常规使用.     

血液灌流串联血液透析救治小儿重度中毒方法的探讨——附18例报告

目的 探讨血液灌流(HP)串联血液透析(HD)救治小儿重度中毒的方法。方法 采用200ml肝素鲜血预充的成人管路;血液灌流串联血液透析;肝素以首剂50～70U/kg继以24～30U/kg/h维持,使血液肝素化,对18例患儿进行28例次血液净化治疗。结果 抢救成功率95％,无一例发生出血或凝血。结论 血液灌流串联血液透析救治小儿重度中毒是安全有效的。     

肾功能衰竭合并严重出血患者的透析抗凝方法探讨

对３２例急慢性肾功能衰竭（肾衰）合并出血患者在活化全血凝固时间（ＡＣＴ）和肝素动力学严密监测下，根据临床出血危险性进行透析膜肝素处理高血液流量无抗凝剂透析和（或）个体化小剂量肝素透析。除１例外患者均安全渡过出血危险期。无抗凝剂透析法透析器凝血发生率为１５．５８％，未引起或加重出血。小剂量肝素化抗凝透析中ＡＣＴ延长控制在１０％～５０％，凝血发生率为４．５０％，加重出血发生率为１２．９６％。作者认为：活动性出血肾衰患者，特别是出血部位直接危及生命时，透析膜肝素处理结合高血液流量无抗凝剂血液透析是目前更安全的透析抗凝方法     

改良式吸附法无肝素血液透析治疗的研究及护理体会

目的：探讨有出血及出血倾向的血液透析患者进行改良式吸附法无肝素血液透析联合盐水冲洗法对防止无肝素血液透析过程中易发生凝血的现象有无影响。方法随机抽取2013年2月～2014年2月本院接诊的60例血液透析作为研究对象,按照数字表法随机分为观察组（n＝30）与对照组（n＝30）,对照组予以盐水冲洗法无肝素透析,观察组予以改良式吸附法无肝素透析,观察并比较透析前后两组凝血、生化指标变化、透析器以及管路凝血程度。结果透析后,两组患者均未发生诱发或加重出血的情况,两组凝血4项指标和血小板计数均无明显变化,组间比较无统计学差异（P＞0.05）,改良式吸附法无肝素血液透析过程中间断给予生理盐水冲洗比不给予生理盐水冲洗并无明显的防止透析器及管路凝血的效果。结论改良式吸附法无肝素血液透析在透析过程中追加或不追加生理盐水冲洗并不影响血液透析过程中透析器及血路管凝血效果,无肝素血液透析过程中凝血的发生多与血液流速、患者的血液黏稠度及透析液温度有关。     

人胎盘抗凝蛋白变体的抗凝与抗栓作用

探索新型抗凝蛋白质--人胎盘抗凝蛋白变体(annexin V derivative,AND)抗凝和抑制动脉血栓形成的作用.方法比较实验组动物和对照组动物在用药前,用药后15,30,60 min及停药2 h活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、血浆纤维蛋白原(Fg)含量.用药15 min后用球囊剥脱股动脉内皮并监测股动脉远端的血压,记录脉压为0的时间即血栓完全闭塞血管的时间.最后剪取球囊损伤的股动脉,测量所形成血栓的长度、血栓的湿重和干重.结果抗凝指标用药组在用药后15 min时,其APTT值最长,且APTT值明显长于生理盐水组(P＜0.05),短于肝素组(P＜0.01),肝素组的APTT、TT值明显长于其他3组,PT值各组间差异无统计学意义;对Fg的影响大剂量用药组似乎可以降低Fg的血浆含量;血栓质量无论是湿重还是干重AND组都明显轻于对照组(P＜0.001),大剂量AND组血栓干重显著轻于小剂量组(P＜0.05);小剂量AND组血栓的长度明显短于生理盐水组(P＜0.05),但和肝素组相比,差异无统计学意义(P=0.485),大剂量AND组明显短于生理盐水组(P＜0.01)和肝素组(P＜0.05);脉压为0的时间AND组显著长于对照组(P＜0.05)和肝素组相比,差异无统计学意义.结论AND是一种安全有效的抗凝和抗栓剂,其抗凝作用在用药后15 min时最强.AND抗凝作用弱于普通肝素,但抗栓能力强于普通肝素,在临床治疗血栓性疾病有应用前景.     

Enoxaparin vs. unfractionated heparin for anticoagulation during continuous veno-venous hemofiltration: a randomized controlled crossover study

OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of the low molecular weight heparin enoxaparin as anticoagulant in continuous veno-venous hemofiltration (CVVH) compared with unfractionated heparin. DESIGN: Prospective randomized controlled crossover study. SETTING: Medical and Surgical Intensive Care Unit of a University Hospital. PATIENTS: Forty consecutive adult medical and surgical ICU patients with normal anticoagulation parameters requiring CVVH. INTERVENTION: CVVH was performed with pre-filter fluid replacement at 2500 ml/h and blood flow rates of 180 ml/min. Heparin-treated patients received an initial pre-filter bolus of 30 IU/kg and a maintenance infusion at 7 units/kg h(-1), titrated to achieve a systemic activated partial thromboplastin time (aPTT) of 40-45 s. Enoxaparin-treated patients received an initial pre-filter bolus of 0.15 mg/kg and a maintenance infusion starting at 0.05 mg/kg h(-1), which was subsequently adjusted to maintain systemic anti-factor Xa activity (anti-Xa) at 0.25-0.30 IU/ml. Each patient received both regimens in a crossover design. Maximum treatment duration for each set was 72 h. RESULTS: Patients included had a mean APACHE II score of 22 (10-35). Thirty-seven patients completed both study arms. Mean filter life span was 21.7 h (+/- 16.9 h) for heparin and 30.6 h (+/- 25.3) for enoxaparin (p = 0.017, ANOVA for repeated measures). One major bleeding episode occurred during heparin as well as during enoxaparin treatment. Cost analysis showed average daily costs of 270 and 240 euro for heparin and enoxaparin, respectively. CONCLUSION: Enoxaparin can be safely used for anticoagulation during CVVH resulting in higher filter lifespan compared with unfractionated heparin.     

两种低分子肝素和肝素钙在血液透析中抗凝效果对比研究

目的观察速避凝和法安明两种低分子肝素在血液透析中抗凝效果。方法选择39例常规血液透析患者,随机分3组,分别使用肝素钙、法安明和速避凝抗凝进行血液透析2次。观察透析结束后出血、透析器凝血情况,测量透析器容量及KT/V值,同时检测透析前,透析后30分钟、2和4小时部分凝血酶原时间（APTT）、凝血酶原活动度（PA）、凝血酶原时间（PT）、凝血酶凝固时间（TT）及纤维蛋白原（FIB）含量。结果透析后齿龈出血肝素钙组明显多于法安明组和速避凝组;两种低分子肝素组压迫止血时间明显短于肝素钙组（P均<0.05）;速避凝组体外循环系统血栓形成率最高,与肝素钙组比较P<0.05;但3种肝素使透析器容量下降率及对KT/V值的影响无显著差异。在血液透析过程中,法安明组及速避凝组PT无变化,PA增加,APTT、TT延长,FIB升高;肝素组透析30分钟即出现PT、APTT、TT显著延长,PA降低及FIB升高,并延续至透析结束。结论低分子肝素作为血液透析抗凝剂可起到与肝素钙同样的抗凝效果,同时减少出血倾向。使用速避凝抗凝时,至少应用0.4ml,才可达到理想抗凝效果。     

药物配合康复训练治疗进展性脑梗死60例疗效观察

目的观察奥扎格雷钠联合低分子肝素钙配合康复训练治疗进展性脑梗死的临床疗效。方法选择发病6～48 h内的缺血性进展性脑梗死患者60例,分为观察组与对照组,每组各30例。观察组采用奥扎格雷钠80 mg加生理盐水250 ml静脉滴注,每12小时1次,14 d为1个疗程,加用低分肝素钙0-4 ml皮下注射,每间隔12小时皮下注射1次,连用7 d;对照组采用单纯给予奥扎格雷钠治疗,用法同观察组。两组基础治疗相同,并均进行综合康复治疗。治疗前及治疗后1周对两组患者的血小板计数、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(Fg)进行测定。比较两组的NIHSS评分。结果两组治疗后神经功能缺损程度评分均明显降低,观察组降低尤为明显,与对照组比较有显著性差异(P<0-01);观察组临床显效率为86-7%,明显优于对照组的60-0%(P<0-01)。两组血小板计数、PT、APTT、Fg均在正常范围内,两组均无明显的不良反应。结论奥扎格雷钠联合低分子肝素钙配合康复训练治疗进展性脑梗死安全有效。     

Physiologic and plasma hormone correlates of survival in endotoxic dogs: effects of opiate antagonists

Two groups of awake dogs were given an iv bolus of endotoxin (3.0 mg/kg from Salmonella typhimurium); one group (n = 9) was pretreated with either naloxone (2.0 mg/kg iv bolus with 1.7 mg/kg.h; n = 6) or naltrexone (2.0 mg/kg iv bolus with repeat bolus of 1.0 mg/kg at 1, 3 and 5 h; n = 3) and the second group (n = 10) received no opiate antagonist. All of nine dogs that were pretreated with an antagonist survived for 24 h, compared to only five of ten dogs that were not pretreated. Survival correlated with improved BP (mean of 91 vs. 61 mm Hg) and cardiac output (3.9 vs. 2.45 L/min) measured during the first 3 h after the infliction of shock. However, both antagonist-treated and nonantagonist-treated survivors had BP and cardiac output which were statistically lower than their baseline values or saline-treated controls at comparable times. Nonsurvivors had significantly higher levels of norepinephrine (peak level: 1149 ng/ml) and epinephrine (peak level: 31.29 ng/ml) than survivors. Opiate antagonists thus appeared to increase survival in a subgroup of dogs that might not otherwise have survived if they had not been so treated; this survival was associated with improved hemodynamics, but not with increased adrenergic activity.     

速避凝、赛莱乐联合应用治疗急性脑梗塞的疗效观察

目的:观察速避凝、赛莱乐联合应用对急性脑梗塞的疗效。方法:79例急性脑梗塞患者随机分成两组,治疗组(41例)用速避凝0.4 mL,每12 h注射1次,共用7 d,赛莱乐150 mg加入5％葡萄糖注射液500 mL静脉滴注,1次/d,共15 d。对照组(38例)应用维脑路通0.4加入低分子右旋糖酐500 mL静脉滴注,1次/d,共15d。分别观察两组治疗后的临床疗效和血液流变学改变。结果:治疗组总有效率及显效率分别为92.68％、75.61％;对照组总有效率及显效率分别为81.58％、47.37％,两组比较有显著性差异(P<0.05)。治疗组凝血酶原时间、红细胞压积、纤维蛋白原均比对照组有显著改善(P<0.05)。无继发出血等副作用。结论:速避凝、赛莱乐联合应用治疗急性脑梗塞安全有效。     

Use of ampicillin-sulbactam for treatment of experimental meningitis caused by a beta-lactamase-producing strain of Escherichia coli K-1.

We evaluated the pharmacokinetics and therapeutic efficacy of ampicillin combined with sulbactam in a rabbit model of meningitis due to a beta-lactamase-producing strain of Escherichia coli K-1. Ceftriaxone was used as a comparison drug. The MIC and MBC were 32 and greater than 64 micrograms/ml (ampicillin), greater than 256 and greater than 256 micrograms/ml (sulbactam), 2.0 and 4.0 micrograms/ml (ampicillin-sulbactam [2:1 ratio, ampicillin concentration]) and 0.125 and 0.25 micrograms/ml (ceftriaxone). All antibiotics were given by intravenous bolus injection in a number of dosing regimens. Ampicillin and sulbactam achieved high concentrations in cerebrospinal fluid (CSF) with higher dose regimens, but only moderate bactericidal activity compared with that of ceftriaxone was obtained. CSF bacterial titers were reduced by 0.6 +/- 0.3 log10 CFU/ml/h with the highest ampicillin-sulbactam dose used (500 and 500 mg/kg of body weight, two doses). This was similar to the bactericidal activity achieved by low-dose ceftriaxone (10 mg/kg), while a higher ceftriaxone dose (100 mg/kg) produced a significant increase in bactericidal activity (1.1 +/- 0.4 log10 CFU/ml/h). It appears that ampicillin-sulbactam, despite favorable CSF pharmacokinetics in animals with meningitis, may be of limited value in the treatment of difficult-to-treat beta-lactamase-producing bacteria, against which the combination shows only moderate in vitro activity.     

慢性肾脏病患者低分子肝素抗氧化作用的研究

目的 阐明在慢性肾脏病(chronic kidney disease,CKD)时低分f肝素是否具有抗氧化作用,为临床治疗提供理论依据.方法 选取CKD 3～5期住院患者40例,随机分为低分子肝素(low mo-lecular weight heparin,LMWH)组(速碧体0.4ml/d皮曰卜射,连续10d)及还原型谷胱甘肽(reducedglutathione,GSH)组(泰特1.8g/d加入0.9%NaC1溶液静脉滴注,连续10d).测定2组用药前后血浆氧化应激指标谷胱甘肽氧化物酶(glutathione peroxidase,GSH-PX)、丙二醛(malondialdehyde,MDA)、晚期氧化蛋白产物(advanced oxidation protein products,AOPP),并观察药物不良反应.结果 LMWH及GSH治疗后血浆AOPP水平均显著降低(P<0.05),GSH组AOPP降低值显著高于LMWH组,分别为(4.89±0.66)nmo1/l,和(2.86±0.82)nmol/L,差异有统计学意义(P<0.05);LMWH及GSH治疗后GSH-PX活力均显著升高(P<0.05),LMWH组和GSH组GSH-PX升高值分别为(3.55±1.01)X10~4U/L和(4.77±1.78)X10~4U/L,差异无统计学意义(P>0.05);LMWH治疗前后MDA分别为(5.54±1.66)nmo l/m1和(5.42±1.40)nmo1/ml,差异无统计学意义(P>0.05),GSH治疗后MDA活力比治疗前显著降低,分别为(5.09±1.44)nmol/ml和(4.61±1.30)nmol/ml,差异有统计学意义(P<0.05).两组药物治疗期间均未见明显不良事件.结论 LMWH可以改善CKD患者氧化应激状态,短期应用未见明显不良反应.与GSH相比,LMWH的抗氧化作用稍弱.     

Use of a modified dosing weight for heparin therapy in a morbidly obese patient

OBJECTIVE: To report a case of successful anticoagulation using a modified dosing weight (DW) for unfractionated heparin (UFH) therapy in a morbidly obese female. CASE SUMMARY: A 54-year-old morbidly obese (182.4 kg, 155 cm) white female presented to the emergency department with tachycardia, shortness of breath, and chest pain, and was diagnosed with a pulmonary embolism. Anticoagulation with UFH was initiated. A modified DW of 120 kg was obtained from the average of the actual body weight (ABW) and ideal body weight ( approximately 50 kg). We selected this modified DW to account for heparin's altered volume of distribution in an obese patient and avoid potentially supratherapeutic activated partial thromboplastin times (aPTTs) using ABW and subtherapeutic aPTTs using DW. Therapy was initiated with a bolus dose of 9600 units (80 units/kg x 120 kg) and continuous infusion rate of 2160 units/h (18 units/kg/h x 120 kg). This infusion rate was maintained throughout the course of heparin therapy and was successful in maintaining therapeutic aPTTs. DISCUSSION: Proper diagnosis and rapid initiation of therapy prevent mortality in patients with PE. Although weight-based heparin nomograms provide standardization through initial bolus and continuous infusion recommendations, many do not address dosing in morbidly obese patients. Several retrospective studies have evaluated actual, dosing, and ideal body weights for heparin therapy in obese patients; however, none has evaluated modified DW. In our patient, successful anticoagulation was objectively confirmed. CONCLUSIONS: Further investigation is necessary to determine the optimal DW for UFH in morbidly obese patients presenting with acute thrombosis.     

Lidocaine attenuates acute lung injury induced by a combination of phospholipase A2 and trypsin

OBJECTIVE: Acute severe pancreatitis is often associated with acute lung injury, including acute respiratory distress syndrome. Acute lung injury induced by phospholipase A2 (PLA2) or trypsin, a pancreatic enzyme, is an experimental model resembling acute respiratory distress syndrome. Neutrophils and platelets are thought to play a pivotal role in the pathogenesis of acute respiratory failure. Lidocaine inhibits some aspects of neutrophil and platelet functions. We conducted the current study to assess the effects of pretreatment with lidocaine on acute lung injury induced by a combination of PLA2 and trypsin. DESIGN: Prospective, randomized animal study. SETTING: University research laboratory. SUBJECTS: Twenty-one adult male Japanese White rabbits (weight range, 2.0-2.4 kg). INTERVENTIONS: The animals were mechanically ventilated with a tidal volume of 10 mL/kg and an Fio2 of 0.4, and thereafter, they were randomly assigned to three groups. Acute lung injury was induced by a combination of PLA2 (1000 units/kg/hr) and trypsin (5000 units/kg/hr) infused intravenously for 4 hrs. Immediately before induction of the acute lung injury, the lidocaine treatment group received intravenous lidocaine (2 mg/kg bolus followed by 2 mg/kg/hr) until they were killed. In the nontreatment group, saline was given instead of lidocaine. Rabbits in the nonlung-injury group received saline infusion instead of the pancreatic enzymes. MEASUREMENTS AND MAIN RESULTS: During the experimental period (4 hrs), arterial blood gases, lung mechanics, and peripheral neutrophil and platelet counts were measured. Immediately after killing, the wet weight/dry weight ratio of the lung was recorded. Light microscopic findings (lung injury score and number of neutrophils) were compared between the three groups. The combination of PLA2 and trypsin decreased Pao2, lung compliance, and peripheral counts of neutrophils and platelets and increased alveolar/arterial oxygen tension difference, lung resistance, wet weight/dry weight ratio, and the number of neutrophils in the lung. Lidocaine treatment attenuated these changes. The two pancreatic enzymes caused extensive morphologic lung damage, which was lessened by lidocaine. CONCLUSIONS: We conclude that pretreatment with intravenous lidocaine attenuated the lung injury induced by the pancreatic enzymes. However, further studies are required to determine whether this drug has a therapeutic effect once the lung injury has developed.