HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Richard Ingemansson Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lindberg, L. Articles by Steen, S. Search for Related Content PubMed PubMed Citation Articles by Lindberg, L. Articles by Steen, S.

Ann Thorac Surg 1996;61:956-962
© 1996 The Society of Thoracic Surgeons

---

Original Articles: General Thoracic

Inhalation of Nitric Oxide After Lung Transplantation

Departments of Cardiothoracic Surgery and Anesthesiology and Intensive Care, University Hospital of Lund, Lund, Sweden

Accepted for publication October 31, 1995.

Background. Pulmonary hypertension is a postoperative complication that may adversely affect the outcome of lung transplantation. The effect of nitric oxide (NO) inhalation on pulmonary hemodynamic indices after lung transplantation was studied and compared with findings in control pigs.

Methods. Varying concentrations of NO were inhaled by 5 pigs after left lung transplantation and right pneumonectomy and by 5 controls after right pneumonectomy at an inspired oxygen fraction of 0.21 and 0.5. Hemodynamic data were recorded continuously, and fast circulatory courses were analyzed.

Results. Inhalation of NO reduced pulmonary vascular resistance and mean pulmonary arterial pressure in all pigs, but the decrease was pronounced and dose dependent only at an inspired oxygen fraction of 0.21 in the pigs that had transplantation. These were the only pigs that became hypoxic. With the termination of NO, there was a dose-independent rebound pulmonary vasoconstriction in the controls, especially at an inspired oxygen fraction of 0.21, but not in the pigs that had transplantation. This response was transient and could be blunted with a higher inspired oxygen fraction.

Conclusion. Inhalation of NO reduced pulmonary vascular resistance in the transplanted lung and may be useful in the treatment of pulmonary hypertension after lung transplantation. The rebound pulmonary vasoconstriction with the termination of NO inhalation stresses the need to be aware of this effect and to wean NO carefully in clinical situations. This study showed oxygen dependency, which has to be taken into consideration in dose-response studies involving NO inhalation.

This article has been cited by other articles:

				M. O. Meade, J. T. Granton, A. Matte-Martyn, K. McRae, B. Weaver, P. Cripps, and S. H. Keshavjee A Randomized Trial of Inhaled Nitric Oxide to Prevent Ischemia-Reperfusion Injury after Lung Transplantation Am. J. Respir. Crit. Care Med., June 1, 2003; 167(11): 1483 - 1489. [Abstract] [Full Text] [PDF]

				L. Chen, H. He, E. F. Mondejar, F. Freden, P. Wiklund, K. Alving, and G. Hedenstierna Endothelin-1 and nitric oxide synthase in short rebound reaction to short exposure to inhaled nitric oxide Am J Physiol Heart Circ Physiol, July 1, 2001; 281(1): H124 - H131. [Abstract] [Full Text] [PDF]

				L. T. Eriksson, R. Roscher, R. Ingemansson, and S. Steen Cardiovascular effects of induced hypothermia after lung transplantation Ann. Thorac. Surg., March 1, 1999; 67(3): 804 - 809. [Abstract] [Full Text] [PDF]

				S. C. Body and S. K. Shernan The Utility of Nitric Oxide in the Postoperative Period Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 1998; 2(1): 4 - 30. [Abstract] [PDF]