Loading...
Please wait, while we are loading the content...
Similar Documents
Addition of nitric oxide to oxygen improves cardiopulmonary function in patients with severe COPD.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Germann, Peter Ziesche, Rolf Leitner, Cheryl Roeder, Gesine Urak, G. Zimpfer, Michael |
| Copyright Year | 1998 |
| Abstract | STUDY OBJECTIVE To assess the effect of nitric oxide inhalation on pulmonary hemodynamics and oxygenation in patients with COPD receiving long-term oxygen therapy (LTOT). DESIGN Prospective study. SETTING ICU of a university medical center. PATIENTS A total of 18 (6 female, 12 male) patients with COPD, spontaneously breathing with LTOT. INTERVENTIONS Oxygenation and hemodynamic variables were measured and calculated at an inspired oxygen fraction (FIO2) adjusted to mimic LTOT conditions (control), and then 1 h after each sequential addition of 5, 10, and 20 ppm nitric oxide to the gas mixture. A newly developed device (Pulmonox) provided both the delivery and continuous analysis of nitric oxide and oxidative nitric oxide products. MEASUREMENTS AND RESULTS There was a significant improvement in oxygenation at 5 ppm nitric oxide (PaO2/FIO2 ratio improved from 244+/-37 to 303+/-59, p<0.05), but no further improvement at higher doses (ceiling effect). There was a dose-dependent improvement in hemodynamic variables that was maximal at 20 ppm nitric oxide (mean pulmonary artery pressure decreased from 29+/-7 to 24+/-5 mm Hg, pulmonary vascular resistance index decreased from 565+/-321 to 392+/-215 dyne x s x cm(-5) x m(-2), and right ventricular ejection fraction improved from 34+/-6 to 39+/-7%, all p<0.05). CONCLUSION Prior studies have demonstrated that inhaled nitric oxide may improve or worsen oxygenation in patients with COPD. Our data show an unequivocal improvement in oxygenation (albeit with a ceiling effect at 5 ppm) and pulmonary hemodynamics (dose dependent) in COPD patients receiving LTOT. Further studies are warranted to examine the usefulness of inhaled nitric oxide during acute exacerbations of COPD, or even the possibility of long-term application in patients receiving LTOT. |
| Starting Page | 29 |
| Ending Page | 35 |
| Page Count | 7 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://journal.publications.chestnet.org/pdfaccess.ashx?url=/data/journals/chest/21768/29.pdf |
| PubMed reference number | 9674443v1 |
| Volume Number | 114 |
| Issue Number | 1 |
| Journal | Chest |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Academic Medical Centers Cardiopulmonary Cell Respiration Chronic Obstructive Airway Disease Dietary Mercury Dyne - unit of force Ejection fraction (procedure) Hemodynamics Idiopathic Pulmonary Fibrosis Inspiration function Nitric Oxide Oxygen Therapy Care Partial Pressure Arterial Oxygen to Fraction Inspired Oxygen Ratio Measurement Patients part per million (ppm) |
| Content Type | Text |
| Resource Type | Article |
