Inhaled nitric oxide in 2003: a review of its mechanisms of action

Abstract

P Pu ur rp po os se e: : To review the pulmonary and systemic effects of endogenous nitric oxide and inhaled nitric oxide administered to patients.S So ou ur rc ce e: : A systematic search for experimental data, human case reports, and randomized clinical trials since 1980, the year of discovery of endothelium-derived relaxing factor. P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : Nitric oxide has pulmonary and systemic effects. Inhaled nitric oxide not only causes selective pulmonary vasodilation but also results in pulmonary vasoconstriction of the vessels perfusing non-ventilated alveolae. The systemic effects of inhaled nitric oxide, which include modulation of the distribution of systemic blood flow, increase in renal output, interaction with coagulation, fibrinolysis and platelet functions, alteration of the inflammatory response, are described and the mechanisms of nitric oxide transport are explained. The possible toxicity of inhaled nitric oxide is also discussed.C Co on nc cl lu us si io on n: : The multiple effects of inhaled nitric oxide support its role as a pulmonary and extra-pulmonary medication.

Effects of Inhaled Nitric Oxide on Oxidative Stress and Histopathological and Inflammatory Lung Injury in a Saline-Lavaged Rabbit Model of Acute Lung Injury

“…Also, low INO doses seem to be beneficial, while higher doses may contribute to inflammatory injury. 39 It is therefore possible that the early application of low dose INO (5 ppm) may have attenuated oxidative lung injury in our model.…”

Perioperative Management of Pulmonary Hypertension

“…Hemoglobin is transformed to methemoglobin, which is secondarily reduced to hemoglobin by methemoglobin reductase. Although NO has no systemic hemodynamic effects, it does have extrapulmonary activity (Wang et al, 2003). That is, it interferes with platelet and leukocyte functions, fibrinolysis, and reperfusion injury by inhibiting expression of adhesion molecules at leukocyte surfaces and by activation of sCG, which lead to a rapid increase in platelet cGMP and inhibition of platelet aggregation.…”

Effects of Vitex rotundifolia on radical scavenging and nitric oxide production

“…NO, produced by nNOS and eNOS in nanomolar concentration, play an important role as a neurotransmitter and vasodilator. However, overproduction of NO, mediated by iNOS, intimately correlated with the pathological conditions in inflammation related diseases (Wang et al, 2003). COX (cyclooxygenase), another key enzyme in inflammation, is the rate-limiting enzyme that catalyzes the formation of PGs from arachidonic acid.…”