Inhaled nitric oxide and aerosolized prostaglandin therapies

Abstract

Inhaled nitric oxide (NO) therapy is becoming an indispensable measure in neonatal intensive care to rescue critically ill neonates with hypoxemic respiratory failure. Inhaled NO improves oxygenation and reduces pulmonary hypertension, but it also may have the following beneficial effects: (1) decreasing pulmonary capillary pressure; (2) inhibiting pulmonary microvascular leaks; (3) inhibiting pulmonary leukocyte aggregation and adhesion; (4) inhibiting pulmonary platelet aggregation and adhesion; and (5) inhibiting hypertensive pulmonary vascular changes. Inhaled NO therapy has been receiving much attention as a preventive measure for acute respiratory distress syndrome and pulmonary hypertensive diseases. The indices for improvement of oxygenation and the measures for augmentation of oxygenation during inhaled NO are beginning to be described, but no device for inhaled NO therapy exists which can be used easily and safely by anyone. Aerosolized prostaglandin therapy has not yet been established either. Neither therapy should be performed without obtaining informed consent and institutional approval.