Inhalation of nitric oxide. An innovative therapy for treatment of increased pulmonary vascular resistance

Critical care of patients during pulmonary hypertensive crises is difficult and treatment is hazardous. Conventional therapy has relied on hyperventilation with oxygen and the use of nonselective intravenous vasodilators. The limitations of this approach have prompted clinical investigations of new therapeutic modalities based on recent advances in vascular biology. Inhaled nitric oxide can be used selectively to manipulate the pulmonary vasculature and treat a variety of pulmonary hypertensive disorders. Preliminary studies appear promising as results of properly conducted trials to evaluate efficacy and toxicity are awaited.