Circulation, Vol 83, 2038-2047, Copyright © 1991 by American Heart Association
C Frostell, MD Fratacci, JC Wain, R Jones and WM Zapol
Background. The gas nitric oxide (NO) is an important endothelium- derived
relaxing factor, inactivated by rapid combination with heme in hemoglobin.
Methods and Results. Awake spontaneously breathing lambs inhaled 5-80 ppm
NO with an acutely constricted pulmonary circulation due to either infusion
of the stable thromboxane endoperoxide analogue U46619 or breathing a
hypoxic gas mixture. Within 3 minutes after adding 40 ppm NO or more to
inspired gas, pulmonary hypertension was reversed. Systemic vasodilation
did not occur. Pulmonary hypertension resumed within 3-6 minutes of ceasing
NO inhalation. During U46619 infusion pulmonary vasodilation was maintained
up to 1 hour without tolerance. In the normal lamb, NO inhalation produced
no hemodynamic changes. Breathing 80 ppm NO for 3 hours did not increase
either methemoglobin or extravascular lung water levels nor modify lung
histology compared with control lambs. Conclusions. Low dose inhaled NO
(5-80 ppm) is a selective pulmonary vasodilator reversing both hypoxia- and
thromboxane-induced pulmonary hypertension in the awake lamb [corrected].
ARTICLES
Inhaled nitric oxide. A selective pulmonary vasodilator reversing hypoxic pulmonary vasoconstriction [published erratum appears in Circulation 1991 Nov;84(5):2212]
Department of Anesthesia, Harvard Medical School, Massachusetts General Hospital, Boston.
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Z. Nong, M. Hoylaerts, N. Van Pelt, D. Collen, and S. Janssens Nitric Oxide Inhalation Inhibits Platelet Aggregation and Platelet-Mediated Pulmonary Thrombosis in Rats Circ. Res., November 19, 1997; 81(5): 865 - 869. [Abstract] [Full Text]
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D. L. Wessel, I. Adatia, L. J. Van Marter, J. E. Thompson, J. W. Kane, A. R. Stark, and S. Kourembanas Improved Oxygenation in a Randomized Trial of Inhaled Nitric Oxide for Persistent Pulmonary Hypertension of the Newborn Pediatrics, November 1, 1997; 100(5): e7 - e7. [Abstract] [Full Text] [PDF]
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M. L. Fisher and S. C. Body Physiology of One-Lung Ventilation Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 1997; 1(3): 236 - 255. [Abstract] [PDF]
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 E. Tzeng and T. R. Billiar Nitric Oxide and the Surgical Patient: Identifying Therapeutic Targets Arch Surg, September 1, 1997; 132(9): 977 - 982. [Abstract] [PDF]
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H. Schütte, F. Grimminger, J. Otterbein, R. Spriestersbach, K. Mayer, D. Walmrath, and W. Seeger Efficiency of Aerosolized Nitric Oxide Donor Drugs to Achieve Sustained Pulmonary Vasodilation J. Pharmacol. Exp. Ther., August 1, 1997; 282(2): 985 - 994. [Abstract] [Full Text]
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Y. Mitani, K. Maruyama, and M. Sakurai Prolonged Administration of L-Arginine Ameliorates Chronic Pulmonary Hypertension and Pulmonary Vascular Remodeling in Rats Circulation, July 15, 1997; 96(2): 689 - 697. [Abstract] [Full Text]
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S. R. HOPKINS, E. C. JOHNSON, R. S. RICHARDSON, H. WAGNER, M. DE ROSA, and P. D. WAGNER Effects of Inhaled Nitric Oxide on Gas Exchange in Lungs with Shunt or Poorly Ventilated Areas Am. J. Respir. Crit. Care Med., July 1, 1997; 156(2): 484 - 491. [Abstract] [Full Text]
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 N. D. Hillman, I. M. Cheifetz, D. M. Craig, P. K. Smith, R. M. Ungerleider, and J. N. Meliones INHALED NITRIC OXIDE, RIGHT VENTRICULAR EFFICIENCY, AND PULMONARY VASCULAR MECHANICS: SELECTIVE VASODILATION OF SMALL PULMONARY VESSELS DURING HYPOXIC PULMONARY VASOCONSTRICTION J. Thorac. Cardiovasc. Surg., June 1, 1997; 113(6): 1006 - 1013. [Abstract] [Full Text]
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N. Finer Inhaled Nitric Oxide and Hypoxic Respiratory Failure in Infants With Congenital Diaphragmatic Hernia Pediatrics, June 1, 1997; 99(6): 838 - 845. [Abstract] [Full Text] [PDF]
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G. Ahlborg and J. M. Lundberg Nitric oxide-endothelin-1 interaction in humans J Appl Physiol, May 1, 1997; 82(5): 1593 - 1600. [Abstract] [Full Text] [PDF]
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E. P. Chen, H. B. Bittner, F. Tull, D. Craig, R. D. Davis, and P. Van Trigt NITRIC OXIDE IMPROVES PULMONARY VASCULAR IMPEDANCE, TRANSPULMONARY EFFICIENCY, AND LEFT VENTRICULAR FILLING IN CHRONIC PULMONARY HYPERTENSION J. Thorac. Cardiovasc. Surg., May 1, 1997; 113(5): 849 - 857. [Abstract] [Full Text]
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S. Fujino, I. Nagahiro, A. N. Triantafillou, C. H. R. Boasquevisque, M. Yano, J. D. Cooper, and G. A. Patterson Inhaled Nitric Oxide at the Time of Harvest Improves Early Lung Allograft Function Ann. Thorac. Surg., May 1, 1997; 63(5): 1383 - 1389. [Abstract] [Full Text]
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R. C. King, O. A. R. Binns, R. C. Kanithanon, J. T. Cope, R. L. Chun, K. S. Shockey, C. G. Tribble, and I. L. Kron Low-Dose Sodium Nitroprusside Reduces Pulmonary Reperfusion Injury Ann. Thorac. Surg., May 1, 1997; 63(5): 1398 - 1404. [Abstract] [Full Text]
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P. Vaida, C. Kays, D. Riviere, P. Techoueyres, and J.-L. Lachaud Pulmonary diffusing capacity and pulmonary capillary blood volume during parabolic flights J Appl Physiol, April 1, 1997; 82(4): 1091 - 1097. [Abstract] [Full Text] [PDF]
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A. Gamillscheg, G. Zobel, B. Urlesberger, J. Berger, D. Dacar, J. I. Stein, B. Rigler, H. Metzler, and A. Beitzke INHALED NITRIC OXIDE IN PATIENTS WITH CRITICAL PULMONARY PERFUSION AFTER FONTAN-TYPE PROCEDURES AND BIDIRECTIONAL GLENN ANASTOMOSIS J. Thorac. Cardiovasc. Surg., March 1, 1997; 113(3): 435 - 442. [Abstract] [Full Text]
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H. Aly, R. Sahni, and J.-T. Wung Weaning strategy with inhaled nitric oxide treatment in persistent pulmonary hypertension of the newborn Arch. Dis. Child. Fetal Neonatal Ed., March 1, 1997; 76(2): 118F - 122. [Abstract] [Full Text]
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The Neonatal Inhaled Nitric Oxide Study Group Inhaled Nitric Oxide in Full-Term and Nearly Full-Term Infants with Hypoxic Respiratory Failure N. Engl. J. Med., February 27, 1997; 336(9): 597 - 604. [Abstract] [Full Text] [PDF]
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J. D. Roberts, J. R. Fineman, F. C. Morin, P. W. Shaul, S. Rimar, M. D. Schreiber, R. A. Polin, M. S. Zwass, M. M. Zayek, I. Gross, et al. Inhaled Nitric Oxide and Persistent Pulmonary Hypertension of the Newborn N. Engl. J. Med., February 27, 1997; 336(9): 605 - 610. [Abstract] [Full Text] [PDF]
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S. G. S. Emil, J. E. Berkeland, and J. B. Atkinson Nitric Oxide Dose Response During Moderate and Severe Hypoxia in Swine Ann. Thorac. Surg., February 1, 1997; 63(2): 414 - 418. [Abstract] [Full Text]
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C. Adrie, K. D. Bloch, P. R. Moreno, W. E. Hurford, J. L. Guerrero, R. Holt, W. M. Zapol, H. K. Gold, and M. J. Semigran Inhaled Nitric Oxide Increases Coronary Artery Patency After Thrombolysis Circulation, October 15, 1996; 94(8): 1919 - 1926. [Abstract] [Full Text]
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K. Okabayashi, A. N. Triantafillou, M. Yamashita, M. Aoe, S. R. DeMeester, J. D. Cooper, and G. A. Patterson CARDIAC AND PULMONARY REPLACEMENTINHALED NITRIC OXIDE IMPROVES LUNG ALLOGRAFT FUNCTION AFTER PROLONGED STORAGE J. Thorac. Cardiovasc. Surg., August 1, 1996; 112(2): 293 - 299. [Abstract] [Full Text]
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H. Date, A. N. Triantafillou, E. P. Trulock, M. S. Pohl, J. D. Cooper, and G.A. Patterson INHALED NITRIC OXIDE REDUCES HUMAN LUNG ALLOGRAFT DYSFUNCTION J. Thorac. Cardiovasc. Surg., May 1, 1996; 111(5): 913 - 919. [Abstract] [Full Text]
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G. J. Vlahakes Management of Pulmonary Hypertension and Right Ventricular Failure: Another Step Forward Ann. Thorac. Surg., April 1, 1996; 61(4): 1051 - 1052. [Full Text]
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U. Scherrer, L. Vollenweider, A. Delabays, M. Savcic, U. Eichenberger, G.-R. Kleger, A. Fikrle, P. E. Ballmer, P. Nicod, and P. Bartsch Inhaled Nitric Oxide for High-Altitude Pulmonary Edema N. Engl. J. Med., March 7, 1996; 334(10): 624 - 630. [Abstract] [Full Text] [PDF]
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