Effect of Nitric Oxide on Oxygenation and Hemodynamics in Infants after Cardiac Surgery

Sadao, Kawasalu; Shinozaki, Masaru; Morinaga, Toshihiko; Naito, Yoshiro; Takagaki, Yusaku

doi:10.1111/j.1525-1594.1997.tb00691.x

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…[24] Administered as continuous inhalation via face mask, iNO can selectively decrease PAP and PVR without reducing cardiac index or systemic vascular resistance. [24] Inhaled NO has also been used in other contexts, such as perioperatively for cardiac surgery, [25][26][27][28][29][30][31][32][33] right heart failure after insertion of the left ventricular assist device, [34][35][36][37] cardiogenic shock due to right ventricle myocardial infarction, [38] and pulmonary ischemia-reperfusion injury. [39][40][41][42][43][44] Because the pulmonary vasodilator effects of NO are transient, it is administered continuously during inspiration, with careful monitoring of NO and NO 2 concentrations.…”

Section: Inhaled Nitric Oxidementioning

confidence: 99%

“…[ 24 ] Administered as continuous inhalation via face mask, iNO can selectively decrease PAP and PVR without reducing cardiac index or systemic vascular resistance. [ 24 ] Inhaled NO has also been used in other contexts, such as perioperatively for cardiac surgery, [ 25–33 ] right heart failure after insertion of the left ventricular assist device, [ 34–37 ] cardiogenic shock due to right ventricle myocardial infarction, [ 38 ] and pulmonary ischemia‐reperfusion injury. [ 39–44 ]…”

Section: Inhaled Nitric Oxidementioning

confidence: 99%

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Clinical Perspectives with Long‐Term Pulsed Inhaled Nitric Oxide for the Treatment of Pulmonary Arterial Hypertension

et al. 2012

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Pulmonary arterial hypertension (PAH) is a chronic, progressive disease of the pulmonary vasculature with a high morbidity and mortality. Its pathobiology involves at least three interacting pathways – prostacyclin (PGI2), endothelin, and nitric oxide (NO). Current treatments target these three pathways utilizing PGI2 and its analogs, endothelin receptor antagonists, and phosphodiesterase type-5 (PDE-5) inhibitors. Inhaled nitric oxide (iNO) is approved for the treatment of hypoxic respiratory failure associated with pulmonary hypertension in term/near-term neonates. As a selective pulmonary vasodilator, iNO can acutely decrease pulmonary artery pressure and pulmonary vascular resistance without affecting cardiac index or systemic vascular resistance. In addition to delivery via the endotracheal tube, iNO can also be administered as continuous inhalation via a facemask or a pulsed nasal delivery. Consistent with a deficiency in endogenously produced NO, long-term pulsed iNO dosing appears to favorably affect hemodynamics in PAH patients, observations that appear to correlate with benefit in uncontrolled settings. Clinical studies and case reports involving patients receiving long-term continuous pulsed iNO have shown minimal risk in terms of adverse events, changes in methemoglobin levels, and detectable exhaled or ambient NO or NO2. Advances in gas delivery technology and strategies to optimize iNO dosing may enable broad-scale application to long-term treatment of chronic diseases such as PAH.

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Section: Inhaled Nitric Oxidementioning

confidence: 99%

“…[ 24 ] Administered as continuous inhalation via face mask, iNO can selectively decrease PAP and PVR without reducing cardiac index or systemic vascular resistance. [ 24 ] Inhaled NO has also been used in other contexts, such as perioperatively for cardiac surgery, [ 25–33 ] right heart failure after insertion of the left ventricular assist device, [ 34–37 ] cardiogenic shock due to right ventricle myocardial infarction, [ 38 ] and pulmonary ischemia‐reperfusion injury. [ 39–44 ]…”

Section: Inhaled Nitric Oxidementioning

confidence: 99%