Tim Higenbottam, Tom Siddons et al (Divison of Clincial Sciences sheffield University, UK)
Commentary – A therapeutic role for chronic inhaled nitric oxide.
Lancet, Vol.356, August 5, 2000, pg. 446-447.
Inhaled nitric oxide (NO) is a unique selective pulmonary vasodilator, which rapidly combines with oxy-haemoglobin to form methaemoglobin and nitrate in the alveolar capillaries. This combination ensures that the predominant effects are on the pulmonary vessels.
Inhaled NO is a potential treatment for the many forms of pulmonary hypertension. Acutely inhaled NO at maximum doses is about half as effective a pulmonary vasodilator as IV prostacyclin. In hypoxic lung disease such as COPD, pulmonary hypertension increases risk of death. Inhaled NO is about twice as effective a pulmonary vasodilator as oxygen.
Preliminary results from a randomized controlled study in Vienna, Austria, have shown that administration of spiked inhaled NO to patients with COPD on long-term oxygen therapy causes a sustained decrease in pulmonary artery pressure at 3 months without causing hypoxia. Results of long-term studies of inhaled NO in COPD are awaited.