Document Detail

Pulsed delivery of inhaled nitric oxide to patients with primary pulmonary hypertension: an ambulatory delivery system and initial clinical tests.
MedLine Citation:
PMID:  8769509     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Inhaled nitric oxide (NO) has been shown to be a selective pulmonary vasodilator in certain patients with primary pulmonary hypertension (PPH).
OBJECTIVES: The purpose of this study was to design and test a system for delivery of NO to awaken, ambulatory patients with PPH and to evaluate this system in the home setting.
METHODS: The ambulatory delivery system consisted of a tank of 80 ppm of NO (balance N2), a modified gas-pulsing device, and nasal cannulas. The pulsing device was set to deliver NO for 0.1 s at the beginning of each inspiration.
RESULTS: Using this system, eight patients with PPH were studied with pulmonary artery catheters in place. Inhalation of NO led to significant reductions in both mean pulmonary arterial pressure (PAPm) (51 +/-12 to 43 +/- 10 mm Hg; p=0.001) and pulmonary vascular resistance (PVR) (790 +/- 285 to 620 +/- 208 dyne x s x cm-5; p=0.01). Three of the eight patients had both greater than 20% and greater than 30% decreases in PAPm and PVR, respectively. No exhaled NO or N02 was detectable in any of the eight patients. One patient was discharged home from the hospital on a regimen of inhaled NO. At 9 months, no adverse effects were noted and the system was working well.
CONCLUSIONS: Pulsed delivery of inhaled NO to ambulatory patients with PPH, via nasal prongs, is feasible and, in some patients, leads to significant improvement in pulmonary hypertension. Inhaled 09NO, therefore, may have a role in the long-term treatment of patients with PPH.
R N Channick; J W Newhart; F W Johnson; P J Williams; W R Auger; P F Fedullo; K M Moser
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  109     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1996-10-03     Completed Date:  1996-10-03     Revised Date:  2011-01-14    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1545-9     Citation Subset:  AIM; IM    
Pulmonary and Critical Care Division, University of California at San Diego Medical Center, 92103, USA.
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MeSH Terms
Administration, Inhalation
Blood Pressure
Cardiac Output
Home Care Services
Hypertension, Pulmonary / drug therapy*,  physiopathology
Nitric Oxide / administration & dosage*
Pulmonary Artery / physiopathology
Pulmonary Wedge Pressure
Vascular Resistance
Reg. No./Substance:
10102-43-9/Nitric Oxide

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