Biomaterial Database

Preliminary experience with inhaled nitric oxide for acute pulmonary hypertension after heart transplantation. 1995

T J Williams, and R F Salamonsen, and G Snell, and D Kaye, and D S Esmore

Department of Respiratory Medicine, Alfred Hospital, Melbourne, Australia.

BACKGROUND Substantial interest has developed in the physiologic and therapeutic role of nitric oxide in the last few years. In patients with pulmonary hypertension it appears to be a useful selective pulmonary vasodilator; however, many issues of both staff and patient safety remained unanswered. METHODS This study examines further safety issues and also presents preliminary clinical experience in patients after orthotopic heart transplantation with pulmonary hypertension and right-sided ventricular failure. RESULTS Atmospheric levels of nitric oxide and nitrogen dioxide are 100 times less than occupational health standards. When nitric oxide is used at 70 parts per million in the presence of a fraction of inspired oxygen greater than 0.60, nitrogen dioxide levels in the circuit exceed the published short-term exposure limit of the American Conference of Government Industrial Hygienist of 5 parts per million. CONCLUSIONS Staff safety appears confirmed, but despite encouraging clinical results, further longer term safety and efficacy studies are indicated.

UI	MeSH Term	Description	Entries
D006976	Hypertension, Pulmonary	Increased VASCULAR RESISTANCE in the PULMONARY CIRCULATION, usually secondary to HEART DISEASES or LUNG DISEASES.	Pulmonary Hypertension
D009569	Nitric Oxide	A free radical gas produced endogenously by a variety of mammalian cells, synthesized from ARGININE by NITRIC OXIDE SYNTHASE. Nitric oxide is one of the ENDOTHELIUM-DEPENDENT RELAXING FACTORS released by the vascular endothelium and mediates VASODILATION. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic GUANYLATE CYCLASE and thus elevates intracellular levels of CYCLIC GMP.	Endogenous Nitrate Vasodilator,Mononitrogen Monoxide,Nitric Oxide, Endothelium-Derived,Nitrogen Monoxide,Endothelium-Derived Nitric Oxide,Monoxide, Mononitrogen,Monoxide, Nitrogen,Nitrate Vasodilator, Endogenous,Nitric Oxide, Endothelium Derived,Oxide, Nitric,Vasodilator, Endogenous Nitrate
D009585	Nitrogen Dioxide	Nitrogen oxide (NO2). A highly poisonous gas. Exposure produces inflammation of lungs that may only cause slight pain or pass unnoticed, but resulting edema several days later may cause death. (From Merck, 11th ed) It is a major atmospheric pollutant that is able to absorb UV light that does not reach the earth's surface.	Nitrogen Peroxide,Dioxide, Nitrogen,Peroxide, Nitrogen
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000280	Administration, Inhalation	The administration of drugs by the respiratory route. It includes insufflation into the respiratory tract.	Drug Administration, Inhalation,Drug Administration, Respiratory,Drug Aerosol Therapy,Inhalation Drug Administration,Inhalation of Drugs,Respiratory Drug Administration,Aerosol Drug Therapy,Aerosol Therapy, Drug,Drug Therapy, Aerosol,Inhalation Administration,Administration, Inhalation Drug,Administration, Respiratory Drug,Therapy, Aerosol Drug,Therapy, Drug Aerosol
D016027	Heart Transplantation	The transference of a heart from one human or animal to another.	Cardiac Transplantation,Grafting, Heart,Transplantation, Cardiac,Transplantation, Heart,Cardiac Transplantations,Graftings, Heart,Heart Grafting,Heart Graftings,Heart Transplantations,Transplantations, Cardiac,Transplantations, Heart