Bench-to-bedside review: Inhaled nitric oxide therapy in adults.
Nitric oxide (NO) is an endogenous mediator of vascular tone and host defence. Inhaled nitric oxide (iNO) results in preferential pulmonary vasodilatation and lowers pulmonary vascular resistance. The route of administration delivers NO selectively to ventilated lung units so that its effect augments that of hypoxic pulmonary vasoconstriction and improves oxygenation. This 'Bench-to-bedside' review focuses on the mechanisms of action of iNO and its clinical applications, with emphasis on acute lung injury and the acute respiratory distress syndrome. Developments in our understanding of the cellular and molecular actions of NO may help to explain the hitherto disappointing results of randomised controlled trials of iNO.
Creagh-Brown
Benedict C
BC
Unit of Critical Care, Faculty of Medicine, Imperial College, London, UK. drbencb@gmail.com
Griffiths
Mark J D
MJ
Evans
Timothy W
TW
D000280:Administration, Inhalation; D000328:Adult; D000755:Anemia, Sickle Cell / Q000188:drug therapy; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy; D009569:Nitric Oxide / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D012128:Respiratory Distress Syndrome / Q000188:drug therapy*; D018497:Ventricular Dysfunction, Right / Q000188:drug therapy
D001993:Bronchodilator Agents; D009569:Nitric Oxide