Effects of inhaled nitric oxide and nebulized prostacyclin on hypoxic pulmonary vasoconstriction in anesthetized sheep

Booke, Michael; Bradford, Darien W.; Hinder, Frank; Harper, Donald D.; Brauchle, Randall W.; Traber, Lillian D.; Traber, Daniel L.

doi:10.1097/00003246-199611000-00014

Cited by 35 publications

(18 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, this is unlikely on the basis of other reports. 10,29,30 In children with PHT and CHD, both iNO and aerosolized iloprost are equally effective in selectively lowering pulmonary vascular resistance through a selective increase in cGMP or cAMP, respectively. However, the combination of both vasodilators failed to prove more potent than either substance alone.…”

Section: Rimensberger Et Al Comparison Of Inhaled Pulmonary Vasodilatorsmentioning

confidence: 99%

Inhaled Nitric Oxide Versus Aerosolized Iloprost in Secondary Pulmonary Hypertension in Children With Congenital Heart Disease

Rimensberger

Spahr-Schopfer²,

Berner³

et al. 2001

Circulation

170

116

View full text Add to dashboard Cite

Background-Inhaled nitric oxide (iNO) has been used to assess the vasodilator capacity of the pulmonary vascular bed in children with congenital heart disease and elevated pulmonary vascular resistance. Inhaled iloprost is a pulmonary vasodilator for the long-term treatment of pulmonary hypertension (PHT). Because these 2 vasodilators act through different pathways (release of cGMP or cAMP, respectively), we compared the pulmonary vasodilator capacity of each. Methods and Results-A total of 15 children with congenital heart disease and PHT who had elevated pulmonary vascular resistance (preoperative, nϭ10; immediately postoperative, nϭ5) were first given 20 ppm of iNO for 10 minutes; then, after baseline values were reached again, they were given aerosolized iloprost at 25 ng ⅐ kg Ϫ1 ⅐ min Ϫ1 for another 10 minutes. Finally, iNO and iloprost were given simultaneously for 10 minutes. With iNO, the pulmonary vascular resistance and systemic vascular resistance ratio decreased from 0.48Ϯ0.38 to 0.27Ϯ0.16 (PϽ0.001). Similarly, iloprost decreased the ratio from 0.49Ϯ0.38 to 0.26Ϯ0.11 (PϽ0.05). The combination had no additional effect on the resistance ratio. Plasma cGMP increased from 17.6Ϯ11.9 to 34.7Ϯ21.4 nmol/L during iNO (PϽ0.01), and plasma cAMP increased from 55.7Ϯ22.9 to 65.1Ϯ21.2 nmol/L during iloprost inhalation (PϽ0.05). Conclusions-In children with PHT and congenital heart disease, both iNO and aerosolized iloprost are equally effective in selectively lowering pulmonary vascular resistance through an increase in cGMP or cAMP, respectively. However, the combination of both vasodilators failed to prove more potent than either substance alone. Aerosolized iloprost might be an alternative to iNO for early testing of vascular reactivity and for the postoperative treatment of acute PHT.

show abstract

Section: Rimensberger Et Al Comparison Of Inhaled Pulmonary Vasodilatorsmentioning

confidence: 99%

Inhaled Nitric Oxide Versus Aerosolized Iloprost in Secondary Pulmonary Hypertension in Children With Congenital Heart Disease

Rimensberger

Spahr-Schopfer²,

Berner³

et al. 2001

Circulation

170

116

View full text Add to dashboard Cite

show abstract

“…The authors state in their discussion that in contrast to our previous investigation [2] no difference in potency was found between inhaled nitric oxide (NO; 20 ppm) and nebulized prostacyclin (PGI 2 ; 10 ng/kg per minute). However, looking at Figs.…”

mentioning

confidence: 63%

Efficacy and practicability of inhaled nitric oxide and aerosolized prostaglandins

Booke¹,

Hinder²

2000

Intensive Care Medicine

View full text Add to dashboard Cite

“…Intravenous PGE 1 (ivPGE 1 ) and PGI 2 , potent vasodilators used empirically in the treatment of NHRF, are associated with systemic hypotension and worsening of oxygenation due to increased venous admixture (2)(3)(4)(5)(6). This has led investigators to explore the delivery of PGE 1 and PGI 2 directly to the lungs as an inhalation, thus minimizing systemic effects and achieving selective pulmonary vasodilation (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Compared to PGI 2 , PGE 1 has a shorter half-life, lower pH (6.3 versus 10.5), bronchodilator action, anti-proliferative and anti-inflammatory effects on the alveolar, interstitial and vascular spaces of the lung (8,(22)(23)(24)(25).…”

Section: Introductionmentioning

confidence: 99%

Toxicity of prolonged high dose inhaled PGE1 in ventilated neonatal pigs

Sood

Dawe

Maddipati

et al. 2008

Pulmonary Pharmacology & Therapeutics

View full text Add to dashboard Cite

Objective-To study the toxicity of inhaled PGE 1 (IPGE 1 ) in healthy ventilated piglets.Methods-Mechanically ventilated anesthetized piglets received either high dose IPGE 1 (IPGE 1 group) or nebulized saline (control group) continuously for 24 hours. Cardio-respiratory parameters, complete blood counts and serum electrolytes were monitored. Lung histology was evaluated by a masked pathologist for the severity (minimal, moderate, and severe) and extent (focal, multifocal, and diffuse) of histologic injury.Results-Ten neonatal pigs were instrumented. Four received nebulized saline and six received high dose IPGE 1 . There was no evidence of adverse cardio-respiratory effects, bronchial irritation or hypernatremia related to IPGE 1 . Diffuse/multifocal alveolar edema and focal polymorphonuclear infiltration was observed in both the control and IPGE 1 groups suggesting that alveolar alterations may be secondary to effects of mechanical ventilation. The most distinct histomorphological abnormalities observed in the IPGE 1 animals were focal ulceration, flattening of the bronchial epithelium and loss of cilia of moderate to severe degree in the trachea and bronchi.Conclusion-In healthy piglets, inhalation of high dose IPGE 1 was not associated with adverse cardiorespiratory effects, bronchial irritation, or hypernatremia and produced minimal signs of pulmonary toxicity even after 24 hours. Prolonged inhalation of high dose PGE 1 therefore appears safe in newborn piglets.

show abstract

Effects of inhaled nitric oxide and nebulized prostacyclin on hypoxic pulmonary vasoconstriction in anesthetized sheep

Cited by 35 publications

References 27 publications

Inhaled Nitric Oxide Versus Aerosolized Iloprost in Secondary Pulmonary Hypertension in Children With Congenital Heart Disease

Inhaled Nitric Oxide Versus Aerosolized Iloprost in Secondary Pulmonary Hypertension in Children With Congenital Heart Disease

Efficacy and practicability of inhaled nitric oxide and aerosolized prostaglandins

Toxicity of prolonged high dose inhaled PGE1 in ventilated neonatal pigs

Contact Info

Product

Resources

About