Pulmonary vascular resistance inhaled nitric oxide effect

Other experimental reproductive effects. Human systemic effects by inhalation pulmonary vascular resistance changes, cough, dyspnea, and other pulmonary changes. Mutation data reported. Violent reaction with cyclohexane, F2, formaldehyde, alcohols, nitrobenzene, petroleum, toluene. When heated to decomposition it emits toxic fumes of NOx. See also NITRIC OXIDE. 

Winberg, P., Lundell, B., and Gustafsson, L. E. (1994). Effect of inhaled nitric oxide on raised pulmonary vascular resistance in children with congenital heart disease. Br. Heart J, 71, 282-286. 

We challenged 12 patients with congenital heart disease and pulmonary hypertension preoperatively in the cardiac catheterization laboratory and nine postoperative patients (after cardiopulmonary bypass) with a 2-min infusion of 10 M acetylcholine into the pulmonary artery. The nine postoperative patients received a 15-min trial of inhaled nitric oxide following the infusion of acetylcholine. The results are shown in Figs. 4 and 5. The decrease in pulmonary artery pressure and resistance in the preoperative patients in response to acetylcholine was markedly attenuated postoperatively. The percentage reductions in pulmonary artery pressure preoperatively were 27% 4% and 9% 2% P < 0.003) postoperatively. Similarly, pulmonary vascular resistance decreased by 46% 5% compared to 11% 4% P < 0.002). However, the response to inhaled nitric oxide in the postoperative patients was marked vasodilation contrasted with the blunted effect of acetylcholine. Mean pulmonary artery pressure (34.4 2.6 versus... 

FIGURE 7 Percentage changes in hemodynamic variables from baseline values during a 15-rain administration of inhaled nitric oxide in postoperative neonates with no residual anatomic obstruction to pulmonary blood flow. There was a marked pulmonary vasodilating effect. HR, Heart rate Cl, cardiac index BP, systemic artery pressure SVR, systemic vascular resistance PAP, mean pulmonary artery pressure PVR, pulmonary vascular resistance. 

FIGURE 9 The effects of 80-ppm nitric oxide (NO) inhalation in six patients with transient graft dysfunction after lung transplantation. Pulmonary artery pressure (PAp), pulmonary vascular resistance index (PVRI), and intrapulmonary shunt fraction (Qs/Qt) decreased significantly, while arterial oxygen pressure (PaOi increased. [Adapted and reproduced with permission from Adatia et al. (77).]... 

Alternatively, the increased pulmonary vascular resistance may be due to an increase in a circulating vasoconstrictor such as endothelin or thromboxane, both of which have been reported to be elevated in children with congenital heart disease following cardiopulmonary bypass. It is noteworthy that the excretion of thromboxane has been found to be elevated during a pulmonary hypertensive crisis ° and that in animal studies inhaled nitric oxide is effective in reversing the pulmonary vasoconstriction induced by thromboxane mimetics. ... 

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