Inhaled and exhaled nitric oxide

Inhaled nitric oxide (NO) is used to treat various cardiopulmonary disorders associated with pulmonary hypertension. The rationale is based on the fact that NO, given by inhalation, only dilates those pulmonary vessels that perfuse well-ventilated lung units. As a result, pulmonary gas exchange is i...

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Vydané v:	Cellular and molecular life sciences : CMLS Ročník 55; číslo 8; s. 1103 - 1112
Hlavní autori:	Thébaud, B., Arnal, J.-F., Mercier, J. C., Dinh-Xuan, A.-T.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Switzerland Springer Nature B.V 01.07.1999 Birkhäuser Verlag
Predmet:	Administration, Inhalation Adult Allergies Animals Asthma Asthma - diagnosis Asthma - metabolism Blood flow Breath Tests Child Clinical trials Congenital Abnormalities - diagnosis Congenital Abnormalities - drug therapy Cystic fibrosis Gas exchange Humans Hypertension Hypertension, Pulmonary - drug therapy Infant, Newborn Inhalation Lungs Measurement techniques Molecular biology Nitric oxide Nitric Oxide - administration & dosage Nitric Oxide - analysis Nitric Oxide - metabolism Nitric Oxide - therapeutic use Oxygenation Paranasal sinus Paranasal Sinus Diseases - diagnosis Paranasal Sinus Diseases - metabolism Paranasal sinuses Pediatrics Polyposis Pulmonary arteries Pulmonary Circulation - drug effects Pulmonary Gas Exchange - drug effects Pulmonary hypertension Respiration Respiratory distress syndrome Respiratory Distress Syndrome, Adult - drug therapy Respiratory Distress Syndrome, Newborn - drug therapy Respiratory Hypersensitivity - diagnosis Respiratory Hypersensitivity - metabolism Respiratory tract Respiratory Tract Diseases - diagnosis Respiratory Tract Diseases - metabolism Sensitivity analysis Sinus Sinuses Sinusitis Vascular Resistance - drug effects Vasoconstriction Ventilation
ISSN:	1420-682X, 1420-9071
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Popis
Shrnutí:	Inhaled nitric oxide (NO) is used to treat various cardiopulmonary disorders associated with pulmonary hypertension. The rationale is based on the fact that NO, given by inhalation, only dilates those pulmonary vessels that perfuse well-ventilated lung units. As a result, pulmonary gas exchange is improved while pulmonary vascular resistance is reduced and pulmonary blood flow is increased. Inhaled NO has been successfully applied to treat persistent pulmonary hypertension of the newborn, reducing the need for extracorporeal life support. Although pulmonary hypertension and altered vasoreactivity contribute to profound hypoxaemia in adult and paediatric acute respiratory distress syndrome (ARDS), the benefit of inhaled NO still remains to be established in patients with ARDS. ARDS is a complex response of the lung to direct or indirect insults, leading to pulmonary vasoconstriction and various inflammatory responses. Recent randomized trials suggest that inhaled NO only causes a transient improvement in oxygenation. Whether this effect is important in the long-term management of ARDS remains to be established. NO, measured in the exhaled breath, is an elegant and non-invasive means to monitor inflammation of the upper and lower respiratory tract. In the normal upper airways, the bulk of exhaled NO originates from the paranasal sinuses. Exhaled NO is increased in nasal allergy and decreased in cystic fibrosis, nasal polyposis and chronic sinusitis. That NO production is increased in asthmatic airways is also well established. However, several questions still need to be addressed, in particular evaluation of the sensitivity and specificity of the measurement techniques, and assessment of the bronchodilator action of endogenous NO.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Article-2 ObjectType-Feature-1 ObjectType-Review-3 content type line 23
ISSN:	1420-682X 1420-9071
DOI:	10.1007/s000180050360