title: Carboxyhemoglobin formation secondary to nitric oxide therapy in the setting of interstitial lung disease and pulmonary hypertension.
abstract: Carbon monoxide (CO) has been widely recognized as an exogenous poison, although endogenous mechanisms for its formation involve heme-oxygenase (HO) isoforms, more specifically HO-1, in the setting of oxidative stress such as acute respiratory distress syndrome, sepsis, trauma, and nitric oxide use have been studied. In patients with refractory hypoxemia, inhaled nitric oxide (iNO) therapy is used to selectively vasodilate the pulmonary vasculature and improve ventilation-perfusion match. Inhaled nitric oxide is rapidly inactivated on binding to hemoglobin in the formation of nitrosyl- and methemoglobin in the pulmonary vasculature. Hence, inhaled nitric oxide has minimal systemic dissemination. Several experimental design studies involving lab rats have demonstrated increased levels of carboxyhemoglobin and exhaled CO as a result of nitric oxide HO-1 induction.
authors.affiliation: North Shore University Hospital, Manhasset, and Beth Israel Medical Center, New York, NY, USA.
authors.forename: Phillip
authors.initials: P
authors.lastname: Ruisi
authors.forename: Michael
authors.initials: M
authors.lastname: Ruisi
mesh_terms: D000280:Administration, Inhalation; D002263:Carboxyhemoglobin / Q000378:metabolism*; D004305:Dose-Response Relationship, Drug; D045462:Endothelium-Dependent Relaxing Factors / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D017563:Lung Diseases, Interstitial / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D008875:Middle Aged; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use*; D010092:Oximetry; D014664:Vasodilation / Q000187:drug effects
chemical_list: D045462:Endothelium-Dependent Relaxing Factors; D009569:Nitric Oxide; D002263:Carboxyhemoglobin