Key result
Inhaled nitric oxide effectively reduces pulmonary vascular resistance in patients with pulmonary hypertension, though its clinical application requires careful monitoring for toxicity and rebound effects.
Nitric oxide and emerging therapies like phosphodiesterase inhibitors effectively reduce pulmonary vascular resistance in pulmonary hypertension, particularly in perioperative and critical care settings.
Cautious perioperative use may be considered in pulmonary hypertension; leaves open comparative trials versus newer agents.
Pulmonary hypertension is a serious complication of a number of lung and heart diseases that is characterized by peripheral vascular structural remodeling and loss of vascular tone. Nitric oxide can modulate vascular injury and interrupt elevation of pulmonary vascular resistance selectively; however, it can also produce cytotoxic oxygen radicals and exert cytotoxic and antiplatelet effects. The balance between the protective and adverse effects of nitric oxide is determined by the relative amount of nitric oxide and reactive radicals. Nitric oxide has been shown to be clinically eff ective in the treatment of congenital heart disease, mitrial valvular disease combined with pulmonary hypertension and in orthotropic cardiac transplantation patients. Additionally, new therapeutic modalities for the treatment of pulmonary hypertension, phosphodiesterase inhibitors, natriuretic peptides and aqueous nitric oxide are also eff ective for treatment of elevated pulmonary vascular resistance. (Korean
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Ji-Yeon Sim (2010) conducted a review in Pulmonary hypertension. Nitric oxide was evaluated. Inhaled nitric oxide effectively reduces pulmonary vascular resistance in patients with pulmonary hypertension, though its clinical application requires careful monitoring for toxicity and rebound effects.
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