Basal and nitroglycerin-induced exhaled nitric oxide before and after cardiac surgery with cardiopulmonary bypass

Kovesi, T.; Royston, David; Yacoub, Magdi; Marczin, Nándor

doi:10.1093/bja/aeg114

Cited by 20 publications

(27 citation statements)

References 43 publications

(28 reference statements)

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“…24 As a reference, Figure 1a depicts such a response in a patient undergoing bypass surgery before CPB. Figure 1b and c demonstrates that there is very little change in exhaled NO after GTN administration in lung transplant recipients when measured approximately 1 hour after reperfusion during hemostatic and hemodynamic stability.…”

Section: Resultsmentioning

confidence: 99%

“…18,19,29 -32 Because basal exhaled NO mainly reflects the relatively large amount of NO release from the airway compartment, 33,34 we speculated that such changes in exhaled NO might represent airway epithelial cell dysfunction and/or oxidative stress in the vicinity of these cells. 24,26 To further investigate the fate of NO pathways in the microvascular lung compartment, one can deliver exogenous NO to the pulmonary circulation and monitor evolution of this NO in exhaled breath. 18,23,[35][36][37] We have suggested that GTN-induced exhaled NO might be a useful tool to monitor metabolic function of the pulmonary microvasculature.…”

Section: Discussionmentioning

confidence: 99%

“…24 This group consisted of 10 patients undergoing myocardial revascularization (coronary artery bypass grafting; CABG) with CPB.…”

Section: Patientsmentioning

confidence: 99%

“…18,24,25 Statistical comparison among the groups was performed using analysis of variance (ANOVA) and Student-Neuman-Keuls post hoc tests. Statistical significance was accepted at p Ͻ 0.05.…”

Section: Chemiluminescence Analysis Of No and Data Analysismentioning

confidence: 99%

“…18,23 We have also established the influence of a clinical form of relatively short and incomplete lung ischemia-reperfusion injury on both basal and GTN-induced exhaled NO, such as that occurring during routine cardiac surgery, utilizing cardiopulmonary bypass (CPB). 24 In this study we sought to establish the influence of more prolonged and total lung ischemia and reperfusion on these parameters during lung transplantation.…”

mentioning

confidence: 99%

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Dynamics of Nitroglycerin-induced Exhaled Nitric Oxide After Lung Transplantation: Evidence of Pulmonary Microvascular Injury?

Gál

Kovesi

Royston

et al. 2007

The Journal of Heart and Lung Transplantation

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Background:In search of real-time molecular correlates to ischemia-reperfusion-induced lung injury, we explored the hypothesis that liberation of nitric oxide (NO) into exhaled breath after pulmonary microvascular bioconversion of nitroglycerin (GTN) is attenuated in clinical lung transplantation. Methods:Exhaled NO was measured under basal conditions and after intravenous administration of GTN in patients undergoing lung transplantation. Patients undergoing routine cardiac surgery served as controls. Basal and GTN-induced exhaled NO was also measured in donors before retrieval and after implantation in recipients. Results:The characteristic GTN-induced exhaled NO response observed in cardiac surgical patients before cardiopulmonary bypass and in lung transplant and multiple-organ donors was nearly totally abolished in lung transplant recipients. This response was also attenuated to a lesser degree in the routine cardiac surgery patients after cardiopulmonary bypass. Conclusions: These results suggest a graded influence of time-factored complete and partial ischemia on GTN-induced evolution of NO into exhaled breath, providing biochemical evidence for a degree of microvascular injury, which can be monitored non-invasively at the bedside.

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Section: Resultsmentioning

confidence: 99%