Acute Effects of Inhaled Nitric Oxide on Pulmonary and Cardiac Function in Preterm Infants with Evolving Bronchopulmonary Dysplasia

Athavale, Kamlesh; Claure, Nelson; D'Ugard, Carmen; Everett, Ruth; Swaminathan, Sethuraman; Bancalari, Eduardo

doi:10.1038/sj.jp.7211216

Cited by 8 publications

(3 citation statements)

References 41 publications

(39 reference statements)

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“…These findings are consistent with data in a smaller preterm infant cohort 17 and data Figure 2 Repeated measurements of Rexp and Ckg during study gas administration. Repeated measurements of Rexp and Ckg were documented over a 2-week period after administration of study gas.…”

Section: Discussionsupporting

confidence: 81%

The effect of inhaled nitric oxide on pulmonary function in preterm infants

et al. 2007

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Objective: Bronchopulmonary dysplasia (BPD) in preterm infants is associated with impaired alveolar growth, inflammation and airway hyperreactivity. In animal models of BPD, inhaled nitric oxide (NO) improves alveolar growth and inhibits airway smooth muscle proliferation. This study was designed to assess the effect of inhaled NO on resistance and compliance in ventilated preterm infants with evolving BPD.Study Design: Expiratory resistance and compliance of the respiratory system were measured in 71 ventilated preterm infants, p32 weeks gestation, randomized to NO (n ¼ 34) versus placebo (n ¼ 37) for X24 days at 7 to 21 days of life.Result: At baseline expiratory resistance (231±71 versus 215±76 cm H 2 O l À1 s À1) and compliance (0.49±0.14 versus 0.53±0.13 ml cm H 2 O À1 kg À1 ) were comparable between placebo and NO groups, respectively. There was no effect of NO on expiratory resistance or compliance at 1 h, 1 week or 2 weeks of study gas administration.Conclusion: NO had no short-or medium-term effect on expiratory resistance or compliance in ventilated preterm infants.

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Section: Discussionsupporting

confidence: 81%

The effect of inhaled nitric oxide on pulmonary function in preterm infants

et al. 2007

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“…Previous reports on the effects of iNO on lung mechanics gave contradictory results: Zayek et al 38 did not find any effect of iNO on Raw and TV in newborn lambs with PH; Zobel et al 6 demonstrated that iNO and inhaled PGI 2 do not change lung mechanics (included static compliance); Dupuy et al 39 demonstrated in guinea pig that iNO reduces pulmonary Raw; Potter et al 40 reported that iNO decreases Raw in newborn piglet; Athavale et al 41 found an improvement of lung compliance, but not of Raw in pre-term infants with evolving bronchopulmonary dysplasia; and finally, McCurnin et al 42 found that iNO increases Cdyn and decreases Raw in a baboon model of chronic lung disease. Moreover, Zobel et al 6 and Ragaller et al 43 excluded in animal models of lung injury any effects of PGI 2 on pulmonary mechanics.…”

Section: Discussionmentioning

confidence: 99%

Inhaled nitric oxide combined with prostacyclin and adrenomedullin in acute respiratory failure with pulmonary hypertension in piglets

Dani¹,

Pavoni²,

Corsini³

et al. 2007

Pediatric Pulmonology

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Our aim was to evaluate if the combined inhalation of both nitric oxide (iNO) and aerosolized prostacyclin or iNO and adrenomedullin (ADM) is more effective in lowering pulmonary arterial pressure (PAP) and improving oxygenation than nitric oxide alone in an animal model with pulmonary hypertension (PH). Moreover, we studied the effect on pulmonary mechanics, surfactant activity, and pulmonary oxidative stress of the different treatments. Twenty-eight piglets with acute lung injury induced by lung lavages with saline were randomized to receive nitric oxide, nitric oxide plus prostacyclin, nitric oxide plus ADM or saline, after. Dynamic compliance, tidal volume, and airway resistance were measured. Lung tissue oxidation was evaluated by measuring total hydroperoxide and advanced oxidation protein products in bronchial aspirate samples. Surface surfactant activity was studied using Capillary Surfactometer. Inhaled nitric oxide combined with prostacyclin or ADM was more effective than nitric oxide alone in lowering PAP and improving oxygenation. Nitric oxide alone or combined increased lung compliance and tidal volume, and decreased airway resistance. No effects on surfactant surface activity and lung tissue oxidation were observed. The treatment with nitric oxide alone or combined with prostacyclin or ADM were effective in decreasing mean PAP and improving oxygenation in a piglet model of PH. However, nitric oxide plus prostacyclin and nitric oxide plus ADM were more effective than nitric oxide alone. The combination of aerosolized prostacyclin and ADM with nitric oxide might have a role in the treatment of infants with PH refractory to nitric oxide alone.

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“…Some reports have been published describing no significant effects of inhaled NO on respiratory system resistance in preterm infants [26,27], also affected by the respiratory syncytial virus [28]. Belik et al [29] showed that the content and the activity of the NOS competitor arginase in the rat lungs exhibit significant reduction with increasing age of the animals, from fetal life to newborns and adults.…”

Section: Discussionmentioning

confidence: 99%

The Effect of N<sup>G</sup>-Nitro-<i>L</i>-Arginine Methyl Ester, a Nitric Oxide Synthase Inhibitor, on Respiratory Mechanics in Rats

Rubini

2011

Respiration

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Background: Data describing the inhibitory effects of nitric oxide synthase (NOS) on respiratory mechanics are conflicting, and no data are available concerning possible effects on the viscoelasticity of the respiratory system, on the inspiratory work of breathing (WOB) or on respiratory system hysteresis. Objectives: The aim of this study was to measure the effects of NOS inhibition by N^G-nitro-L-arginine methyl ester (L-NAME) on respiratory mechanics in normal anesthetized rats. Methods: Using the end-inflation occlusion method, it was possible to quantify the ohmic and viscoelastic airway resistance and elastance of the respiratory system. Ohmic resistance is the normalized-to-flow pressure dissipation due to viscous forces opposing the airflow in the airways, as predicted by the Poiseuille law. Viscoelastic resistance is the normalized-to-flow pressure dissipation due to the resistance of respiratory system tissue to deformation during inflation, which is recovered after the arrest of the inspiratory flow (stress relaxation). The inspiratory WOB, its elastic and resistive components, and hysteresis were also calculated. Results:L-NAME induced an increment in the ohmic airway resistance and in the resistive ohmic inspiratory WOB. The viscoelastic resistance due to stress relaxation and the elastic properties of the respiratory system were not modified, and no effect was detected on the related components of the inspiratory WOB and on hysteresis. Conclusions: NO acts in normal rats to reduce the ohmic component of airway resistance, decreasing the ohmic inspiratory WOB. The elastic and viscoelastic components are unaltered. Hysteresis is also unaltered, suggesting that NO has negligible effects on alveolar surfactant activity.

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Acute Effects of Inhaled Nitric Oxide on Pulmonary and Cardiac Function in Preterm Infants with Evolving Bronchopulmonary Dysplasia

Abstract: Low-dose iNO had no acute effects on lung function, cardiac function and oxygenation in evolving BPD.

Cited by 8 publications

References 41 publications

The effect of inhaled nitric oxide on pulmonary function in preterm infants

The effect of inhaled nitric oxide on pulmonary function in preterm infants

Inhaled nitric oxide combined with prostacyclin and adrenomedullin in acute respiratory failure with pulmonary hypertension in piglets

The Effect of N<sup>G</sup>-Nitro-<i>L</i>-Arginine Methyl Ester, a Nitric Oxide Synthase Inhibitor, on Respiratory Mechanics in Rats

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