Inhaled nitric oxide therapy

Abstract

Inhaled nitric oxide (NO) therapy is a measure to improve pulmonary hypertension and ventilation-perfusion inequality by administering NO gas. Basic studies suggest that low concentrations of inhaled NO decreases the increased pulmonary capillary pressure, depresses the increased permeability of pulmonary vasculature, inhibits the increased agglutination and adhesion of leucocytes to the lungs, depresses the increased agglutination and adhesion of platelets, and decreases the hypertensive remodeling of pulmonary vasculature. In the emergency and critical care settings, quite a lot of life-threatening patients with the exacerbation of pulmonary hypertension and/or hypoxemia by trauma, surgery and infections are admitted for treatment. In this paper, we discuss the present status of inhaled NO therapy from the point of view of an emergency and critical care physician.