Small-Dose Inhaled Nitric Oxide Attenuates Hemodynamic Changes After Pulmonary Air Embolism in Dogs

Abstract

In this study, we evaluated the protective effects of inhaled nitric oxide in a pulmonary air embolism setting. Nitric oxide attenuated the hemodynamic changes induced by pulmonary air embolism without improving pulmonary oxygenation.

Inhaled nitric oxide improves hemodynamics during a venous air infusion (VAI) in dogs

“…The inhalation of 3 ppm NO attenuated pulmonary hypertension and the decrease in CI and MAP after an acute massive pulmonary air embolism without improving pulmonary oxygenation [14]. Other studies have also shown positive hemodynamic effects of NO inhalation after acute pulmonary embolism with microspheres [11±13].…”

“…The concentration of 3 ppm was chosen because this amount of NO improves hemodynamics after massive air embolism [14]. NO 40 ppm was administered because this concentration produces maximum pulmonary vasodilation [24,25].…”

“…Favorable hemodynamic effects were demonstrated after acute pulmonary microsphere embolism [11±13]. Similarly, previous inhalation of a low dose of NO (3 ppm) attenuates the hemodynamic changes associated with a massive pulmonary air embolism, without improving pulmonary oxygenation [14].…”

Protective effects of atorvastatin in rat models of acute pulmonary embolism: Involvement of matrix metalloproteinase-9*

“…It has been shown that activation of the nitric oxide (NO)-cyclic guanosine monophosphate pathway attenuates acute pulmonary embolism-induced hemodynamic derangements (15)(16)(17)(18)(19)(20)(21), maybe through mechanisms including negative modulation of lung MMP-2 and MMP-9 activities after APE (7). Another way to activate the NO-cyclic guanosine monophosphate pathway is by using statins (22)(23)(24).…”

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“…In the presence of pulmonary vasoconstriction, the higher pulmonary vascular resistance then the greater the inhaled NO vasodilator effect. Recently it has been demonstrated that inhaled NO could attenuate the pulmonary vasoconstriction caused by active mediators in an experimental model of massive air pulmonary embolism (PE) [2]. …”