Document Detail


CO and NO pulmonary diffusing capacity during pregnancy: Safety and diagnostic potential.
MedLine Citation:
PMID:  20149901     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This paper reviews the scientific evidence for the safety of carbon monoxide (CO) and nitric oxide (NO) inhalation to measure pulmonary diffusing capacity (DL(CO) and DL(NO)) in pregnant women and their fetuses. In eight earlier studies, 650 pregnant women had DL(CO) measurements performed at various times during pregnancy, with a minimum of two to four tests per session. Both pregnant subjects that were healthy and those with medical complications were tested. No study reported adverse maternal, fetal, or neonatal outcomes from the CO inhalation in association with measuring DL(CO). Eleven pregnant women, chiefly with pulmonary hypertension, and 1105 pre-term neonates, mostly with respiratory failure, were administered various dosages of NO (5-80ppm for 4 weeks continuously in pregnant women, and 1-20ppm for 15min to 3 weeks for the neonates). NO treatment was found to be an effective therapy for pregnant women with pulmonary hypertension. In neonates with respiratory failure and pulmonary hypertension, NO therapy improved oxygenation and survival and has been associated with only minor, transient adverse effects. In conclusion, maternal carboxyhemoglobin ([Hb(CO)]) levels can safely increase to 5% per testing session when the dose-exposure limit is 0.3% CO inhalation for <or=3min, and for NO, 80ppm for <or=3min. The risk of late fetal or neonatal death from increased Hb(CO) from diffusion testing is considerably less than the risk of death from all causes reported by the Centers for Disease Control, and is therefore considered "minimal risk".
Authors:
Gerald S Zavorsky; Arlin B Blood; Gordon G Power; Lawrence D Longo; Raul Artal; Emanuel J Vlastos
Publication Detail:
Type:  Journal Article; Review     Date:  2010-02-10
Journal Detail:
Title:  Respiratory physiology & neurobiology     Volume:  170     ISSN:  1878-1519     ISO Abbreviation:  Respir Physiol Neurobiol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-23     Completed Date:  2010-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140022     Medline TA:  Respir Physiol Neurobiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  215-25     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier B.V. All rights reserved.
Affiliation:
Department of Obstetrics, Gynecology and Women's Health, School of Medicine, Saint Louis University, Saint Mary's Health Center, 6420 Clayton Road, Suite 290, Saint Louis, MO 63117, USA. zavorsky@slu.edu
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MeSH Terms
Descriptor/Qualifier:
Carbon Monoxide / administration & dosage*,  adverse effects
Female
Humans
Hypertension, Pulmonary / diagnosis*,  physiopathology
Nitric Oxide / administration & dosage*,  adverse effects
Pregnancy / physiology*
Pregnancy Complications
Pulmonary Diffusing Capacity / methods*
Chemical
Reg. No./Substance:
10102-43-9/Nitric Oxide; 630-08-0/Carbon Monoxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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