Inhaled Nitric Oxide in the Preoperative Evaluation of Pulmonary Hypertension in Heart Transplant Patients

OBJECTIVE: To evaluate the role of inhaled nitric oxide (iNO) in adult heart or lung transplant recipients. DATA SOURCES: Pertinent literature was identified via a MEDLINE search (1966–July 2004). DATA SYNTHESIS: Pulmonary hypertension leading to right ventricular failure and ischemic reperfusion injury are complications following heart or lung transplant, respectively. A study of 16 heart transplant patients showed improvement in hemodynamic parameters and preservation of right ventricular function, but no improvement in mortality using iNO. Studies of lung transplant patients showed no benefit of iNO on mechanical ventilation duration, hospital length of stay, or mortality, but some studies indicate an improvement in hemodynamic parameters. CONCLUSIONS: iNO shows hemodynamic benefits in early postoperative heart transplant patients with preexisting pulmonary hypertension, and variable hemodynamic benefits in lung transplant recipients. Currently, morbidity and mortality data are not favorable for either indication; use of iNO is supportive and requires further study.

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Inhaled Nitric Oxide Through a Noninvasive Ventilation Device to Assess Reversibility of Pulmonary Hypertension in Selecting Recipients For Heart Transplant

Transplantation Proceedings ◽

10.1016/j.transproceed.2005.09.151 ◽

2005 ◽

Vol 37 (9) ◽

pp. 4028-4030 ◽

Cited By ~ 16

Author(s):

S. Fojón ◽

C. Fernández-González ◽

J. Sánchez-Andrade ◽

J.M. López-Pérez ◽

L.F. Hermida ◽

...

Keyword(s):

Nitric Oxide ◽

Pulmonary Hypertension ◽

Noninvasive Ventilation ◽

Heart Transplant ◽

Inhaled Nitric Oxide

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Acute Hemodynamic Responses to Inhaled Nitric Oxide in Patients With Limited Scleroderma and Isolated Pulmonary Hypertension

Circulation ◽

10.1161/01.cir.94.3.477 ◽

1996 ◽

Vol 94 (3) ◽

pp. 477-482 ◽

Cited By ~ 23

Author(s):

D.J. Williamson ◽

C. Hayward ◽

P. Rogers ◽

L.L. Wallman ◽

A.D. Sturgess ◽

...

Keyword(s):

Nitric Oxide ◽

Pulmonary Hypertension ◽

Inhaled Nitric Oxide ◽

Hemodynamic Responses ◽

Limited Scleroderma

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Inhaled Nitric Oxide at Birth Reduces Pulmonary Vascular Resistance and Improves Oxygenation in Preterm Lambs

Children ◽

10.3390/children8050378 ◽

2021 ◽

Vol 8 (5) ◽

pp. 378

Author(s):

Satyan Lakshminrusimha ◽

Sylvia F. Gugino ◽

Krishnamurthy Sekar ◽

Stephen Wedgwood ◽

Carmon Koenigsknecht ◽

...

Keyword(s):

Nitric Oxide ◽

Pulmonary Hypertension ◽

Pulmonary Vascular Resistance ◽

Preterm Infants ◽

Vascular Resistance ◽

Inhaled Nitric Oxide ◽

Persistent Pulmonary Hypertension ◽

Inhaled No ◽

Birth Preterm

Resuscitation with 21% O2 may not achieve target oxygenation in preterm infants and in neonates with persistent pulmonary hypertension of the newborn (PPHN). Inhaled nitric oxide (iNO) at birth can reduce pulmonary vascular resistance (PVR) and improve PaO2. We studied the effect of iNO on oxygenation and changes in PVR in preterm lambs with and without PPHN during resuscitation and stabilization at birth. Preterm lambs with and without PPHN (induced by antenatal ductal ligation) were delivered at 134 d gestation (term is 147–150 d). Lambs without PPHN were ventilated with 21% O2, titrated O2 to maintain target oxygenation or 21% O2 + iNO (20 ppm) at birth for 30 min. Preterm lambs with PPHN were ventilated with 50% O2, titrated O2 or 50% O2 + iNO. Resuscitation with 21% O2 in preterm lambs and 50%O2 in PPHN lambs did not achieve target oxygenation. Inhaled NO significantly decreased PVR in all lambs and increased PaO2 in preterm lambs ventilated with 21% O2 similar to that achieved by titrated O2 (41 ± 9% at 30 min). Inhaled NO increased PaO2 to 45 ± 13, 45 ± 20 and 76 ± 11 mmHg with 50% O2, titrated O2 up to 100% and 50% O2 + iNO, respectively, in PPHN lambs. We concluded that iNO at birth reduces PVR and FiO2 required to achieve target PaO2.

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