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Background/Aim: Deterioration of hemodynamic conditions is a serious complication of severe acute pancreatitis (AP). Early colloid resuscitation is a matter of controversy due to the possible deleterious effect on lung function. Previous study demonstrated that inhibition of nitric oxide synthase (iNOS) reverse the effect of albumin on lung damage in burn (Chen LW, J Am Coll Surg, 2005). We hypothesized that this effect could be reproduced in acute pancreatitis (AP).Methods: AP was induced in male Wistar rats by intraductal 2.5% taurocholate injection. To evaluate the effect of albumin on lung damage in AP, animals received intravenously normal saline (Group I) or human albumin (25% in saline) (Group II) immediately after AP. To evaluate the effect of iNOS inhibition on lung damage in AP, iNOS specific inhibitor S-methylisothiourea (SMT) (7.5mg/Kg, IP) was given to animals immediately after AP. The animals were divided into two groups: Group III: normal saline was given after AP and SMT, and Group IV: albumin was given after AP and SMT. After 12 hours all animals were sacrificed and blood was collected for amylase assay. Lung myeloperoxidase (MPO) activity was determined as an index for pulmonary neutrophil sequestration. Pulmonary vascular permeability was quantified by measuring the concentration of Evans blue (EB).Results: Serum amylase levels, lung MPO activities and vascular permeability of lungs were significantly increased after AP. Albumin administrated after AP increased lung permeability (70.92 ± 7.0 µg EB/mg tissue) compared with saline administration (47.41 ± 4.62 µg EB/mg tissue) (p<0.05). However, albumin administration with SMT reduced lung permeability (42.77 ± 9.49 µg EB/mg tissue) compared to albumin administration without SMT (70.92 ± 7.0 µg EB/mg tissue) (p<0.05). There were no significant differences in serum amylase and lung MPO activities among groups.Conclusion: Restoration of extracellular fluid in AP with albumin increased the lung permeability. Inhibition of iNOS before albumin administration reduced this albumin induced damaging effect in AP.