This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (30) Citing Articles via Google Scholar Google Scholar Articles by Tanus-Santos, J. E. Articles by de Nucci, G. Search for Related Content PubMed PubMed Citation Articles by Tanus-Santos, J. E. Articles by de Nucci, G.

---

CARDIOVASCULAR ANESTHESIA

Small-Dose Inhaled Nitric Oxide Attenuates Hemodynamic Changes After Pulmonary Air Embolism in Dogs

Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, São Paulo, Brazil

Address correspondence and reprint requests to Jose Eduardo Tanus-Santos, MD, PhD, Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, PO Box 6111, 13081-970 Campinas, São Paulo, Brazil. Address e-mail to tanus{at}turing.unicamp.br

Inhaled nitric oxide (NO) has been used to treat pulmonary hypertension. Experimental studies have suggested therapeutic effects of NO after pulmonary microembolism. We evaluated the protective effects of NO in dogs during a pulmonary air embolism (PAE). NO (3 ppm) was administered to six anesthetized mongrel dogs (NO group) but not to the seven dogs in the control group. After 20 min, each dog received a venous air injection of 2.5 mL/kg. Hemodynamic evaluation was performed, and blood samples were drawn for blood gas analysis before and after NO inhalation and 5–60 min after the PAE. Both arterial blood pressure and cardiac output were decreased in the control group for >15 min after PAE, whereas NO-treated animals showed only transient hypotension. NO attenuated the pulmonary hypertension after PAE, as demonstrated by small (P < 0.05) increases in pulmonary artery pressure and pulmonary vascular resistance index in NO-treated animals (90% and 135%, respectively) compared with the controls (196% and 282%, respectively). These hemodynamic effects of NO were associated with higher mixed venous O₂ tensions and saturations in the NO group compared with the controls. We conclude that small-dose NO (3 ppm) attenuated the hemodynamic changes induced by PAE in dogs. This protective effect of NO on hemodynamics is not accompanied by improvement in pulmonary oxygenation in this setting.

Implications: In this study, we evaluated the protective effects of inhaled nitric oxide in a pulmonary air embolism setting. Nitric oxide attenuated the hemodynamic changes induced by pulmonary air embolism without improving pulmonary oxygenation.

This article has been cited by other articles:

				D. C. Souza-Costa, T. Zerbini, A. C. Palei, R. F. Gerlach, and J. E. Tanus-Santos L-arginine Attenuates Acute Pulmonary Embolism-Induced Increases in Lung Matrix Metalloproteinase-2 and Matrix Metalloproteinase-9 Chest, November 1, 2005; 128(5): 3705 - 3710. [Abstract] [Full Text] [PDF]

				C. A. Dias-Junior, D. C. Souza-Costa, T. Zerbini, J. B. T. da Rocha, R. F. Gerlach, and J. E. Tanus-Santos The Effect of Sildenafil on Pulmonary Embolism-Induced Oxidative Stress and Pulmonary Hypertension Anesth. Analg., July 1, 2005; 101(1): 115 - 120. [Abstract] [Full Text] [PDF]

				C. A. Dias-Junior, A. Martineau, P. Couture, and A. Denault Pharmacologic Therapy of Acute Pulmonary Embolism * Response Anesth. Analg., January 1, 2004; 98(1): 266 - 267. [Full Text] [PDF]

				J. E. Tanus-Santos Pharmacologic Therapy of Pulmonary Vasoconstriction in Acute Pulmonary Embolism Anesth. Analg., January 1, 2004; 98(1): 273 - 273. [Full Text] [PDF]

				G. Bushman Essentials of Nitric Oxide for the Pediatric (Cardiac) Anesthesiologist Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2001; 5(1): 79 - 90. [Abstract] [PDF]

				J. E. Tanus-Santos, H. Moreno Jr, K. Janata, I. Kurkciyan, and F. Sterz Treatment of Massive Pulmonary Embolism Arch Intern Med, February 12, 2001; 161(3): 481 - 482. [Full Text] [PDF]

				Y. M. Smulders Pathophysiology and treatment of haemodynamic instability in acute pulmonary embolism: the pivotal role of pulmonary vasoconstriction Cardiovasc Res, October 1, 2000; 48(1): 23 - 33. [Abstract] [Full Text] [PDF]

				J. E. Tanus-Santos, W. M. Gordo, A. Udelsmann, M. H. Cittadino, and H. Moreno Jr. Nonselective Endothelin-Receptor Antagonism Attenuates Hemodynamic Changes After Massive Pulmonary Air Embolism in Dogs Chest, July 1, 2000; 118(1): 175 - 179. [Abstract] [Full Text] [PDF]

				J. E. Tanus-Santos, W. M. Gordo, A. Udelsmann, and H. M. Junior The Hemodynamic Effects of Endothelin Receptor Antagonism During a Venous Air Infusion in Dogs Anesth. Analg., January 1, 2000; 90(1): 102 - 102. [Abstract] [Full Text] [PDF]