Inhaled nitric oxide therapy in pregnancy complicated by pulmonary hypertension

Robinson, Julian N.; Banerjee, Rini; Landzberg, Michael J.; Thiet, Mari-Paule

doi:10.1016/s0002-9378(99)70686-1

Cited by 48 publications

(22 citation statements)

References 2 publications

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“…[74] It is also not known whether NO is excreted in human milk or not and is not approved for use by Food and Drug Administration (FDA). However, Michael et al .…”

Section: Mechanical Ventilationmentioning

confidence: 99%

Acute respiratory failure and mechanical ventilation in pregnant patient: A narrative review of literature

Bhatia

Biyani

Mohammed

et al. 2016

J Anaesthesiol Clin Pharmacol

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Physiological changes of pregnancy imposes higher risk of acute respiratory failure (ARF) with even a slight insult and remains an important cause of maternal and fetal morbidity and mortality. Although pregnant women have different respiratory physiology and different causes of ARF, guidelines specific to ventilatory settings, goals of oxygenation and weaning process could not be framed due to lack of large-scale randomized controlled trials. During the 2009 H1N1 pandemic, pregnant women had higher morbidity and mortality compared to nonpregnant women. During this period, alternative strategies of ventilation such as high-frequency oscillatory ventilation, inhalational of nitric oxide, prone positioning, and extra corporeal membrane oxygenation were increasingly used as a desperate measure to rescue pregnant patients with severe hypoxemia who were not improving with conventional mechanical ventilation. This article highlights the causes of ARF and recent advances in invasive, noninvasive and alternative strategies of ventilation used during pregnancy.

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“…[74] It is also not known whether NO is excreted in human milk or not and is not approved for use by Food and Drug Administration (FDA). However, Michael et al .…”

Section: Mechanical Ventilationmentioning

confidence: 99%

Acute respiratory failure and mechanical ventilation in pregnant patient: A narrative review of literature

Bhatia

Biyani

Mohammed

et al. 2016

J Anaesthesiol Clin Pharmacol

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“…[295759] NO has also been used effectively in the peripartum management of patients with PH. [60] Pregnancy in PAH patients who are long-term responders to calcium channel blockers appears to have a particularly good outcome. [54]…”

Section: Pulmonary Hypertension In Pregnancymentioning

confidence: 99%

Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Perioperative management in patients with pulmonary hypertension

Tonelli

Minai

2014

Ann Thorac Med

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Patients with pulmonary hypertension (PH) are being encountered more commonly in the perioperative period and this trend is likely to increase as improvements in the recognition, management, and treatment of the disease continue to occur. Management of these patients is challenging due to their tenuous hemodynamic status. Recent advances in the understanding of the patho-physiology, risk factors, monitoring, and treatment of the disease provide an opportunity to reduce the morbidity and mortality associated with PH in the peri-operative period. Management of these patients requires a multi-disciplinary approach and meticulous care that is best provided in centers with vast experience in PH.In this review, we provide a detailed discussion about oerioperative strategies in PH patients, and give evidence-based recommendations, when applicable.

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“…There are several reports of using inhaled NO in pregnant patients with PAH (Table 4) [Robinson et al 1999;Weiss et al 2000]. In one case report, a pregnant patient with PAH with atrial septal defect and human immunodeficiency virus who presented at 30 weeks' gestation was treated with sildenafil and inhaled NO.…”

Section: Inhaled Nitric Oxidementioning

confidence: 99%

Pulmonary arterial hypertension in pregnant women

Safdar

2012

Ther Adv Respir Dis

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Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling that limits the ability of the pulmonary vascular bed to withstand the physiological changes of pregnancy. Historically, pregnancy in PAH carries a high risk to the parturient. Normal pulmonary vasculature can withstand the hemodynamic and physiological changes associated with pregnancy without the development of respiratory symptomatology. However, in the presence of pulmonary vascular remodeling the capacity to handle these changes is compromised. During pregnancy, increase in cardiac output from the increased intravascular volume can lead to right heart failure. Therefore, all patients with PAH of childbearing potential should receive preconception counseling and be advised to use two methods of contraception. Patients with PAH should be advised against continuing pregnancy if they do become pregnant. According to the literature, deterioration in pregnancy mainly occurs in the second trimester and early in the third trimester; immediately postpartum is the most critical time for patients with PAH. In this review, we will discuss the recent advances in the management of parturient patients with PAH.

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Inhaled nitric oxide therapy in pregnancy complicated by pulmonary hypertension

Cited by 48 publications

References 2 publications

Acute respiratory failure and mechanical ventilation in pregnant patient: A narrative review of literature

Acute respiratory failure and mechanical ventilation in pregnant patient: A narrative review of literature

Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Perioperative management in patients with pulmonary hypertension

Pulmonary arterial hypertension in pregnant women

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