Nitric oxide and the lung: an overview

This brief discussion focuses on the effects of nitric oxide (NO) in the lung. A short introduction of some of the physical characteristics of the NO gas molecule and the endogenous production of NO by the vascular endothelium is addressed first. This is followed by a review of inhaled NO use as a bronchodilator of the airway and recent findings of the endogenous production of NO during positive end-expiratory pressure and the possible role of NO produced in the paranasal sinuses. Next, the use of inhaled NO for both pulmonary hypertension and improvement in oxygenation under a variety of clinical situations is discussed. Finally, some suggestions are given regarding the safe delivery of inhaled NO during clinical applications using a face mask, an anesthesia circuit, and a mechanical ventilator.