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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Bibliographic Details
Published in:Cellular and molecular life sciences : CMLS Vol. 55; no. 8; pp. 1103 - 1112
Main Authors: Thébaud, B., Arnal, J.-F., Mercier, J. C., Dinh-Xuan, A.-T.
Format: Journal Article
Language:English
Published: Switzerland Springer Nature B.V 01.07.1999
Birkhäuser Verlag
Subjects:
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
Online Access:Get full text
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Summary: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.
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ISSN:1420-682X
1420-9071
DOI:10.1007/s000180050360