The response to varying concentrations of inhaled nitric oxide in patients with acute respiratory distress syndrome

被引:52
作者
Lowson, SM [1 ]
Rich, GF [1 ]
McArdle, PA [1 ]
Jaidev, J [1 ]
Morris, GN [1 ]
机构
[1] UNIV VIRGINIA,HLTH SCI CTR,DEPT BIOMED ENGN,CHARLOTTESVILLE,VA 22908
关键词
D O I
10.1097/00000539-199603000-00026
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
We investigated the response to varying concentrations of inhaled nitric oxide (NO) in 18 patients with acute respiratory distress syndrome (ARDS). The study was divided into two parts. In Part 1, 5-40 ppm of inhaled NO was evaluated in 10 patients with ARDS. In Part 2, 0.1-10 ppm of inhaled NO was evaluated in eight patients with ARDS. Inhaled NO significantly (P < 0.05) decreased the mean pulmonary artery pressure (MPAP) and pulmonary vascular resistance index (PVRI), and increased the arterial oxygenation (PaO2) at concentrations of 0.1 to 40 ppm. No dose response was detectable for the pulmonary artery pressure (PAP) or PVRI over this dose range. The increase in PaO2 at 10 ppm of NO was significantly greater than that at 0.1 ppm but not 1 ppm. The decrease in PVRI and the increase in PaO2 were both significantly correlated with the baseline PVRI. While the maximum hemodynamic and oxygenation responses to inhaled NO are achieved at approximately 1 ppm, it appears that the maximum hemodynamic response is observed at lower concentrations (0.1 ppm) of inhaled NO than the improvement in oxygenation (1-10 ppm). Higher concentrations of NO do not produce any further change in these variables. It appears that the baseline PVRI may be the best marker predicting a beneficial response to NO.
引用
收藏
页码:574 / 581
页数:8
相关论文
共 21 条
  • [1] PROLONGED INHALATION OF LOW CONCENTRATIONS OF NITRIC-OXIDE IN PATIENTS WITH SEVERE ADULT-RESPIRATORY-DISTRESS-SYNDROME - EFFECTS ON PULMONARY HEMODYNAMICS AND OXYGENATION
    BIGATELLO, LM
    HURFORD, WE
    KACMAREK, RM
    ROBERTS, JD
    ZAPOL, WM
    [J]. ANESTHESIOLOGY, 1994, 80 (04) : 761 - 770
  • [2] CHARACTERIZATION OF INTENSIVE-CARE UNIT PATIENTS USING A MODEL-BASED ON THE PRESENCE OR ABSENCE OF ORGAN DYSFUNCTIONS AND OR INFECTION - THE ODIN MODEL
    FAGON, JY
    CHASTRE, J
    NOVARA, A
    MEDIONI, P
    GIBERT, C
    [J]. INTENSIVE CARE MEDICINE, 1993, 19 (03) : 137 - 144
  • [3] INHALED NITRIC-OXIDE IN INFANTS REFERRED FOR EXTRACORPOREAL MEMBRANE-OXYGENATION - DOSE-RESPONSE
    FINER, NN
    ETCHES, PC
    KAMSTRA, B
    TIERNEY, AJ
    PELIOWSKI, A
    RYAN, CA
    [J]. JOURNAL OF PEDIATRICS, 1994, 124 (02) : 302 - 308
  • [4] TIME-COURSE AND DOSE-RESPONSE OF NITRIC-OXIDE INHALATION FOR SYSTEMIC OXYGENATION AND PULMONARY-HYPERTENSION IN PATIENTS WITH ADULT-RESPIRATORY-DISTRESS-SYNDROME
    GERLACH, H
    ROSSAINT, R
    PAPPERT, D
    FALKE, KJ
    [J]. EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, 1993, 23 (08) : 499 - 502
  • [5] LOWSON SM, 1994, ANESTHESIOLOGY, V81, pA124
  • [6] MONCHI M, 1994, AM J RESP CRIT CARE, V149, pA423
  • [7] AN EXPANDED DEFINITION OF THE ADULT RESPIRATORY-DISTRESS SYNDROME
    MURRAY, JF
    MATTHAY, MA
    LUCE, JM
    FLICK, MR
    [J]. AMERICAN REVIEW OF RESPIRATORY DISEASE, 1988, 138 (03): : 720 - 723
  • [8] NITROGEN-DIOXIDE PRODUCTION DURING MECHANICAL VENTILATION WITH NITRIC-OXIDE IN ADULTS - EFFECTS OF VENTILATOR INTERNAL VOLUME, AIR VERSUS NITROGEN DILUTION, MINUTE VENTILATION, AND INSPIRED OXYGEN FRACTION
    NISHIMURA, M
    HESS, D
    KACMAREK, RM
    RITZ, R
    HURFORD, WE
    [J]. ANESTHESIOLOGY, 1995, 82 (05) : 1246 - 1254
  • [9] EFFECT OF ENDOGENOUS AND INHALED NITRIC-OXIDE ON THE VENTILATION-PERFUSION RELATIONSHIPS IN OLEIC-ACID LUNG INJURY
    PUTENSEN, C
    RASANEN, J
    DOWNS, JB
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1994, 150 (02) : 330 - 336
  • [10] INHALED NITRIC-OXIDE IN ACUTE RESPIRATORY-FAILURE - DOSE-RESPONSE CURVES
    PUYBASSET, L
    ROUBY, JJ
    MOURGEON, E
    STEWART, TE
    CLUZEL, P
    ARTHAUD, M
    POETE, P
    BODIN, L
    KORINEK, AM
    VIARS, P
    [J]. INTENSIVE CARE MEDICINE, 1994, 20 (05) : 319 - 327