Exhaled nitric oxide as a marker of lung injury in coronary artery bypass surgery

Cuthbertson, Brian H.; Stott, S; Webster, Nigel R.

doi:10.1093/bja/aef171

Cited by 28 publications

(12 citation statements)

References 11 publications

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“…16 As exhaled nitric oxide levels decrease with worsening oxygenation, such a measurement has the potential of a near patient test, which can alert the clinicians to developing acute lung injury. 17 Despite all the theoretical reasons for more severe lung injury in conventional CABG, no difference has been found so far between conventional and OPCAB surgery in regards to pulmonary gas exchange abnormalities. [18][19][20] Our data is the latest addition to the previous reports.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Pulmonary Gas Exchange in OPCAB Versus Conventional CABG

Syed

Fawzy

Farag

et al. 2004

Heart, Lung and Circulation

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Section: Discussionmentioning

confidence: 99%

Comparison of Pulmonary Gas Exchange in OPCAB Versus Conventional CABG

Syed

Fawzy

Farag

et al. 2004

Heart, Lung and Circulation

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“…The respiratory tract is accessible by noninvasive investigation, because NO is present and can be measured in exhaled gas (10). Few studies have evaluated the concentration of exhaled NO in ventilated critically ill patients, and they have shown a decrease in exhaled NO after surgery (18,9). It could be hypothesized that this unexpected decrease (inasmuch as proinflammatory mediators are known to upregulate inducible NO synthase) in exhaled NO could be a marker of immune paralysis in critically ill patients.…”

mentioning

confidence: 99%

Decreased exhaled nitric oxide as a marker of postinsult immune paralysis

Attalah¹,

Honore²,

Eddahibi³

et al. 2004

Journal of Applied Physiology

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Nitric oxide (NO) regulates neutrophil migration and alveolar macrophage functions such as cytokine synthesis and bacterial killing, both of which are impaired in immune paralysis associated with critical illness. The aim of this study was to determine whether NO is involved in immune paralysis and whether exhaled NO measurement could help to monitor pulmonary defenses. NO production (protein expression, enzyme activity, end products, and exhaled NO measurements) was assessed in rats after cecal ligation and puncture to induce a mild peritonitis (leading to approximately 20% mortality rate). An early and sustained decrease in exhaled NO was found after peritonitis (from 1 to 72 h) compared with healthy rats [median (25th-75th percentile), 1.5 parts per billion (ppb) (1.2-1.7) vs. 4.0 ppb (3.6-4.3), P < 0.05], despite increased NO synthase-2 and unchanged NO synthase-3 protein expression in lung tissue. NO synthase-2 activity was decreased in lung tissue. Nitrites and nitrates in supernatants of isolated alveolar macrophages decreased after peritonitis compared with healthy rats, and an inhibitory experiment suggested arginase overactivity in alveolar macrophages bypassing the NO substrate. Administration of the NO synthase-2 inhibitor aminoguanidine to healthy animals reproduced the decreased neutrophil migration toward alveolar spaces that was observed after peritonitis, but L-arginine administration after peritonitis failed to correct the defect of neutrophil emigration despite increasing exhaled NO compared with D-arginine administration [4.8 (3.9-5.7) vs. 1.6 (1.3-1.7) ppb, respectively, P < 0.05]. In conclusion, the decrease in exhaled NO observed after mild peritonitis could serve as a marker for lung immunodepression.

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“…At the time of the workshop, there was limited published information on the offline measurement of Fe NO levels in ventilated individuals (103,125,126,130,131). These studies used various methods of gas collection (syringe aspiration, tidal breath collection, and controlled collection with a pump) and different ports of sampling (endotracheal tube, ventilator circuit, and exhaust port of the ventilator).…”

Section: Flow-controlled Single-breath Measurementsmentioning

confidence: 99%

ATS Workshop Proceedings: Exhaled Nitric Oxide and Nitric Oxide Oxidative Metabolism in Exhaled Breath Condensate

Silkoff¹,

Erzurum²,

Lundberg³

et al. 2006

Proceedings of the American Thoracic Society

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and Europe working in the relevant field. Several companies who have developed technologies in the field were also present at all scientific sessions, although they were excluded from the session that dealt with revisions to the ATS statement.The workshop believed that clinical application of exhaled nitric oxide (NO) was ready for asthma, whereas nasal NO could advance to clinical use in primary ciliary dyskinesias. However, exhaled breath condensate (EBC) was not considered ready for clinical application as the now-published recommendations for standardized methods were not ready at the time of the workshop, methodologic issues abounded, and evidence for application of specific markers in specific diseases was deemed inadequate. AIMS OF THE WORKSHOPAim 1: To review developments in the field of fractional concentration of exhaled NO (Fe NO ) measurement.

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Exhaled nitric oxide as a marker of lung injury in coronary artery bypass surgery

Abstract: Further work is required to test whether exhaled NO concentration may be useful in diagnosing the onset of acute lung injury in patients undergoing coronary artery bypass grafting.

Cited by 28 publications

References 11 publications

Comparison of Pulmonary Gas Exchange in OPCAB Versus Conventional CABG

Comparison of Pulmonary Gas Exchange in OPCAB Versus Conventional CABG

Decreased exhaled nitric oxide as a marker of postinsult immune paralysis

ATS Workshop Proceedings: Exhaled Nitric Oxide and Nitric Oxide Oxidative Metabolism in Exhaled Breath Condensate

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