Nitric oxide and prostacyclin treatment of an infant with primary pulmonary hypertension

Ivy, D. Dunbar; Wiggins, James W.; Badesch, David B.; Kinsella, John P.; Kelminson, Leslie L.

doi:10.1016/0002-9149(94)90420-0

Cited by 15 publications

(2 citation statements)

References 17 publications

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“…Noninvasive methods of delivering iNO have been anecdotally described in the literature. The fact that iNO can be delivered effectively by continuous flow nasal cannulae was first demonstrated in a young infant with primary pulmonary hypertension, who was treated with nasal nitric oxide for several weeks until approved for enrollment into the long-term intravenous prostacyclin therapy program 11. iNO via a nasopharyngeal tube was used in a 145-day-old infant with a severely hypoplastic lung and end-stage pulmonary hypertension, in whom clinical improvement was maintained for 7 days 12.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of a Neonate with Idiopathic Persistent Pulmonary Hypertension with Inhaled Nitric Oxide via Nasal Cannula without Mechanical Ventilation

2012

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We report a case study of a term neonate presenting with oxygen desaturation without respiratory distress or acidosis, despite receiving 100% oxygen through a nasal cannula. Echocardiogram showed evidence of persistent pulmonary hypertension of the newborn (PPHN). She was successfully treated with inhaled nitric oxide (iNO) via nasal cannula without requiring mechanical ventilation. In a term neonate with idiopathic PPHN with adequate respiratory drive without any parenchymal lung disease, noninvasive methods of iNO delivery may treat the condition without the complications associated with mechanical ventilation.

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Section: Discussionmentioning

confidence: 99%

Successful Treatment of a Neonate with Idiopathic Persistent Pulmonary Hypertension with Inhaled Nitric Oxide via Nasal Cannula without Mechanical Ventilation

2012

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“…Monitoring of iNO and NO 2 concentrations is mandatory [69,70]. Furthermore, rebound pulmonary vasoconstriction has been observed after withdrawal of iNO resulting in hypoxemia [57] and life-threatening pulmonary hypertension [62,71,72]. In patients with compromised left ventricular (LV) function, iNO may result in acute LV failure and pulmonary edema [73][74][75], possibly caused by a deleterious increase of LV preload (due to increased pulmonary blood flow).…”

Section: Inhalation Of Exogenous Nomentioning

confidence: 99%

Searching the Ideal Inhaled Vasodilator: From Nitric Oxide to Prostacyclin

et al. 2002

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Today, the technique to directly administer vasodilators via the airway to treat pulmonary hypertension and to improve pulmonary gas exchange is widely accepted among clinicians. The flood of scientific work focussing on this new therapeutic concept had been initiated by a fundamental new observation by Pepke-Zaba [1]and Frostell in 1991 [2]: Both scientists reported, that inhalation of exogenous nitric oxide (NO) gas selectively dilates pulmonary vessels without a concomittant systemic vasodilation. No more than another decade ago NO was identified as an important endogenous vasodilator [3]while having merely been regarded an environmental pollutant before that time. Although inhaled NO proved to be efficacious, alternatives were sought-after due to NO’s potential side-effects. In search for the ideal inhaled vasodilator another group of endogenous mediators – the prostanoids – came into the focus of interest. The evidence for safety and efficacy of inhaled prostanoids is – among a lot of other valuable work – based on a series of experimental and clinical investigations that have been performed or designed at the Institute for Surgical Research under the guidance and mentorship of Prof. Dr. med. Dr. h.c. mult. K. Messmer [4-19]. In the following, the current and newly emerging clinical applications of inhaled prostanoids and the experimental data which they are based on, will be reviewed.

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Inhaled Nitric Oxide for the Treatment of Pulmonary Arterial Hypertension

Abman

2013

Handbook of Experimental Pharmacology

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Following the recognition of nitric oxide (NO) as the "endothelium-derived relaxing factor," an explosion of laboratory and clinical research led to the development of inhaled NO as a potential therapy for patients with pulmonary arterial hypertension (PAH). Despite clear demonstration of its selective and potent pulmonary vasodilator properties, inhaled NO therapy has only been formally approved by the US Food and Drug Administration and European Medicine Evaluation Agency for clinical use in the treatment of term and near-term infants with severe persistent pulmonary hypertension of the newborn (PPHN) with acute hypoxemic respiratory failure. Over the past decades, inhaled NO remains the central therapy for PPHN and is commonly used for acute pulmonary vasoreactivity testing during right heart catheterization and for treating pediatric and adult patients with PAH associated with postoperative cardiac surgery, severe respiratory failure, pulmonary hypertension crises, and other disorders. This review will describe the current use of inhaled NO in clinical practice and briefly discuss its potential role for the treatment of chronic PAH.

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Nitric oxide and prostacyclin treatment of an infant with primary pulmonary hypertension

Cited by 15 publications

References 17 publications

Successful Treatment of a Neonate with Idiopathic Persistent Pulmonary Hypertension with Inhaled Nitric Oxide via Nasal Cannula without Mechanical Ventilation

Successful Treatment of a Neonate with Idiopathic Persistent Pulmonary Hypertension with Inhaled Nitric Oxide via Nasal Cannula without Mechanical Ventilation

Searching the Ideal Inhaled Vasodilator: From Nitric Oxide to Prostacyclin

Inhaled Nitric Oxide for the Treatment of Pulmonary Arterial Hypertension

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