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Serum nitrogen oxides during nitric oxide inhalation

E M Valvini1, J D Young

  • 1Dialysis Unit, Middlesex Hospital, London.

British Journal of Anaesthesia
|March 1, 1995
PubMed
Summary

Inhaled nitric oxide (iNO) therapy in a patient with leptospirosis-induced acute respiratory failure led to a significant 13-fold increase in serum nitrogen oxides. This case highlights iNO

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Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Critical Care

Background:

  • Leptospirosis can cause severe respiratory complications, including acute respiratory failure.
  • Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator used in various respiratory conditions.
  • The metabolic fate of nitric oxide (NO) in the context of iNO therapy and severe infection requires further elucidation.

Observation:

  • A patient with acute respiratory failure secondary to leptospirosis received inhaled nitric oxide (iNO) at concentrations of 40 and 90 parts per million (ppm).
  • Following iNO administration, the patient's serum concentrations of nitrogen oxides (nitrates and nitrites) demonstrated a substantial 13-fold increase.

Findings:

  • Inhaled nitric oxide therapy in leptospirosis-induced respiratory failure is associated with a marked elevation in systemic nitrogen oxide metabolites.
  • The study observed a significant correlation between iNO dosage and the increase in serum nitrates and nitrites.

Implications:

  • This case suggests a potential systemic metabolic pathway for inhaled nitric oxide in patients with severe infections.
  • Understanding the mechanisms of nitrogen oxide formation and elimination during iNO therapy is crucial for optimizing treatment and monitoring patients.
  • Further research is warranted to explore the clinical significance and potential therapeutic modulation of these nitrogen oxide changes.

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