Nitric oxide contamination of hospital compressed air improves gas exchange in patients with acute lung injury.
OBJECTIVE
We tested the hypothesis that NO contamination of hospital compressed air also improves PaO(2) in patients with acute lung injury (ALI) and following lung transplant (LTx).


METHODS
Prospective clinical study.


METHODS
Cardiothoracic intensive care unit.


METHODS
Subjects following cardiac surgery (CABG, n=7); with ALI (n=7), and following LTx (n=5).


METHODS
Four sequential 15-min steps at a constant FiO(2) were used: hospital compressed air-O(2) (H1), N(2)-O(2) (A1), repeat compressed air-O(2) (H2), and repeat N(2)-O(2) (A2).


RESULTS
NO levels were measured from the endotracheal tube. Cardiorespiratory values included PaO(2) were measured at the end of each step. FiO(2) was 0.46+/-0.05, 0.53+/-0.15, and 0.47+/-0.06 (mean+/-SD) for three groups, respectively. Inhaled NO levels during H1 varied among subjects (30-550 ppb, 27-300 ppb, and 5-220 ppb, respectively). Exhaled NO levels were not detected in 4/7 of CABG (0-300 ppb), 3/6 of ALI (0-140 ppb), and 3/5 of LTx (0-59 ppb) patients during H1, whereas during A1 all but one patient in ALI and three CABG patients had measurable exhaled NO levels (P<0.05). Small but significant decreases in PaO(2) occurred for all groups from H1 to A1 and H2 to A2 (132-99 Torr and 128-120 Torr, P <0.01, respectively). There was no correlation between inhaled NO during H1 and exhaled NO during A1 or the change in PaO(2) from H1 to A1.


CONCLUSIONS
Low-level NO contamination improves PaO(2) in patients with ALI and following LTx.
Department of Anaesthesiology, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
P Seow Koon
PS
Tan
F
F
Genc
E
E
Delgado
J A
JA
Kellum
M R
MR
Pinsky
D000388:Air / Q000032:analysis*; D001026:Coronary Artery Bypass; D004780:Environment, Controlled; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D016040:Lung Transplantation; D009569:Nitric Oxide / Q000008:administration & dosage* / Q000009:adverse effects; D010100:Oxygen / Q000032:analysis*; D010414:Pennsylvania; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects
D014665:Vasodilator Agents; D009569:Nitric Oxide; D010100:Oxygen