The selective pulmonary vasodilatory effect of inhaled DETA/NO, a novel nitric oxide donor, in ARDS-a pilot human trial.
OBJECTIVE
To examine the effects of inhaled NONOates in patients with acute respiratory distress syndrome (ARDS).


METHODS
Case-series, phase I clinical trial.


METHODS
A multidisciplinary intensive care unit in a tertiary teaching hospital.


METHODS
Five consecutive patients with ARDS (men; age range, 47-76 years).


METHODS
DETA/NO (150 micromol) was aerosolized into the lungs of patients on mechanical ventilation via the endotracheal tube over 20 minutes. Hemodynamic parameters were measured and blood samples were taken before, during, and after inhalation.


RESULTS
Compared to baseline values, pulmonary vascular resistance decreased until the end of the study period (180 minutes) while intrapulmonary shunting decreased significantly up to 45 min after DETA/NO aerosol administration. Inhaled DETA/NO had no effect on the systemic circulation (systemic blood pressure or cardiac output).


CONCLUSIONS
Inhaled DETA/NO is a selective pulmonary vasodilator in patients with ARDS. However, a larger number of patients is required to confirm the findings of this pilot study.
Lam
Chen-Fuh
CF
School of Medicine and Pharmacology, University of Western Australia, Crawley, Australia.
Van Heerden
P Vernon
PV
Blott
John
J
Roberts
Brigit
B
Ilett
Kenneth F
KF
D000280:Administration, Inhalation; D000368:Aged; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D020030:Nitric Oxide Donors / Q000494:pharmacology* / Q000627:therapeutic use*; D009573:Nitrites / Q000097:blood; D010865:Pilot Projects; D011073:Polyamines / Q000494:pharmacology / Q000627:therapeutic use; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D012128:Respiratory Distress Syndrome / Q000188:drug therapy*; D014226:Triazenes / Q000494:pharmacology* / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000494:pharmacology* / Q000627:therapeutic use*
C105351:1-hydroxy-2-oxo-3,3-bis(2-aminoethyl)-1-triazene; D020030:Nitric Oxide Donors; D009573:Nitrites; D011073:Polyamines; D014226:Triazenes; D014665:Vasodilator Agents; C005391:diethylenetriamine