Long-Term Inhalation of Nitric Oxide for a Patient With Primary Pulmonary Hypertension

Koh, Eikan; Niimura, Junko; Nakamura, Tsuneyuki; Yamakage, Hitoyoshi; Takahashi, Hiroaki

doi:10.1253/jcj.62.940

Cited by 10 publications

(3 citation statements)

References 22 publications

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“…The vasoconstriction observed after the sudden withdrawal of inhaled nitric oxide following HBOC-201 infusion is reminiscent of the rebound pulmonary hypertension occurring in adults with acute respiratory distress syndrome and children after cardiac surgery upon sudden withdrawal of nitric oxide inhalation. Slow reduction of the concentration of inhaled nitric oxide has been successful in preventing rebound pulmonary hypertension 37. It is conceivable that slow weaning of inhaled nitric oxide may prevent rebound pulmonary hypertension in patients treated with HBOCs.…”

Section: Discussionmentioning

confidence: 99%

Prevention of the Pulmonary Vasoconstrictor Effects of HBOC-201 in Awake Lambs by Continuously Breathing Nitric Oxide

Yu¹,

Volpato

Chang

et al. 2009

Anesthesiology

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Background Hemoglobin-based oxygen-carrying solutions (HBOC) provide emergency alternatives to blood transfusion to carry oxygen to tissues without the risks of disease transmission or transfusion reaction. Two primary concerns hampering the clinical acceptance of acellular HBOC are the occurrence of systemic and pulmonary vasoconstriction and the maintenance of the heme-iron in the reduced state (Fe+2). We recently demonstrated that pretreatment with inhaled nitric oxide prevents the systemic hypertension induced by HBOC-201 (polymerized bovine hemoglobin) infusion in awake mice and sheep without causing methemoglobinemia. However, the impact of HBOC-201 infusion with or without inhaled nitric oxide on pulmonary vascular tone has not yet been examined. Methods The pulmonary and systemic hemodynamic effects of breathing nitric oxide both before and after the administration of HBOC-201 were determined in healthy, awake lambs. Results Intravenous administration of HBOC-201 (12 ml/kg) induced prolonged systemic and pulmonary vasoconstriction. Pretreatment with inhaled nitric oxide (80 parts per million (ppm) for 1 h) prevented the HBOC-201-induced increase in mean arterial pressure, but not the increase of pulmonary arterial pressure, systemic vascular resistance, or pulmonary vascular resistance. Pretreatment with inhaled nitric oxide (80 ppm, 1 h) followed by breathing a lower concentration of nitric oxide (5 ppm) during and after HBOC-201 infusion prevented systemic and pulmonary vasoconstriction without increasing methemoglobin levels. Conclusions These findings demonstrate that pretreatment with inhaled nitric oxide followed by breathing a lower concentration of the gas during and after administration of HBOC-201 may enable administration of an acellular hemoglobin substitute without vasoconstriction while preserving its oxygen-carrying capacity.

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Section: Discussionmentioning

confidence: 99%

Prevention of the Pulmonary Vasoconstrictor Effects of HBOC-201 in Awake Lambs by Continuously Breathing Nitric Oxide

Yu¹,

Volpato

Chang

et al. 2009

Anesthesiology

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“…or higher) (Atz et al 1996;Oka et al 1996;Koh et al 1998) and is avoided by using less than 5 p.p.m. NO (Koh et al 1998;Betbese¨et al 1996). The dose used in the current study (4.9 mmol breath À1 ) did not cause detectable rebound.…”

Section: Discussionmentioning

confidence: 99%

Pulsed delivery of nitric oxide counteracts hypoxaemia in the anaesthetized horse

Heinonen

Hedenstierna

Meriläinen

et al. 2001

Veterinary Anaesthesia and Analgesia

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“…106 In contrast, inhaled nitric oxide has not been well studied as a long-term therapy for PAH, with only rare case reports and case series appearing in print. [107][108][109] …”

Section: Inhaled Nitric Oxidementioning

confidence: 99%

Treatment for Pulmonary Arterial Hypertension

Mandel¹

2006

Pulmonary Vascular Disease

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Long-Term Inhalation of Nitric Oxide for a Patient With Primary Pulmonary Hypertension

Cited by 10 publications

References 22 publications

Prevention of the Pulmonary Vasoconstrictor Effects of HBOC-201 in Awake Lambs by Continuously Breathing Nitric Oxide

Prevention of the Pulmonary Vasoconstrictor Effects of HBOC-201 in Awake Lambs by Continuously Breathing Nitric Oxide

Pulsed delivery of nitric oxide counteracts hypoxaemia in the anaesthetized horse

Treatment for Pulmonary Arterial Hypertension

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