Inhaled nitric oxide for acute asthma

Abstract

Chipps and Murphy1Chipps B.E. Murphy K.R. Assessment and treatment of acute asthma in children.J Pediatr. 2005; 147: 288-294Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar provided an interesting and timely review on the assessment and treatment of acute asthma; however, they failed to mention a therapy of potential benefit to patients presenting with severe acute asthma: inhaled nitric oxide. We and others have reported on the successful use of inhaled nitric oxide in the treatment of life-threatening status asthmaticus.2Rishani R. El-Khatib M. Mroueh S. Treatment of severe status asthmaticus with nitric oxide.Pediatr Pulmonol. 1999; 28: 451-453Crossref PubMed Scopus (14) Google Scholar, 3Nakagawa T.A. Johnston S.J. Falkos S.A. Gomez R.J. Morris A. Life-threatening status asthmaticus treated with inhaled nitric oxide.J Pediatr. 2000; 137: 119-122Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar Nitric oxide appears to have some bronchodilator activity that is additive to that of the β-2 agonists.4Dupuy P.M. Shore S.A. Drazen J.M. Frostell C. Hill W.A. Zapol W.M. Bronchodilator action of inhaled nitric oxide in guinea pigs.J Clin Invest. 1992; 90: 421-428Crossref PubMed Scopus (279) Google Scholar Through its well-known pulmonary vasodilator effect, it improves ventilation-perfusion matching and reduces hypoxemia.The use of inhaled nitric oxide in asthma has not been studied in any controlled fashion. However, physicians attending to sick children are increasingly familiar with its effective and safe use for other indications. It should be considered in the treatment of critically ill asthmatic patients. Chipps and Murphy1Chipps B.E. Murphy K.R. Assessment and treatment of acute asthma in children.J Pediatr. 2005; 147: 288-294Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar provided an interesting and timely review on the assessment and treatment of acute asthma; however, they failed to mention a therapy of potential benefit to patients presenting with severe acute asthma: inhaled nitric oxide. We and others have reported on the successful use of inhaled nitric oxide in the treatment of life-threatening status asthmaticus.2Rishani R. El-Khatib M. Mroueh S. Treatment of severe status asthmaticus with nitric oxide.Pediatr Pulmonol. 1999; 28: 451-453Crossref PubMed Scopus (14) Google Scholar, 3Nakagawa T.A. Johnston S.J. Falkos S.A. Gomez R.J. Morris A. Life-threatening status asthmaticus treated with inhaled nitric oxide.J Pediatr. 2000; 137: 119-122Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar Nitric oxide appears to have some bronchodilator activity that is additive to that of the β-2 agonists.4Dupuy P.M. Shore S.A. Drazen J.M. Frostell C. Hill W.A. Zapol W.M. Bronchodilator action of inhaled nitric oxide in guinea pigs.J Clin Invest. 1992; 90: 421-428Crossref PubMed Scopus (279) Google Scholar Through its well-known pulmonary vasodilator effect, it improves ventilation-perfusion matching and reduces hypoxemia. The use of inhaled nitric oxide in asthma has not been studied in any controlled fashion. However, physicians attending to sick children are increasingly familiar with its effective and safe use for other indications. It should be considered in the treatment of critically ill asthmatic patients. ReplyThe Journal of PediatricsVol. 149Issue 1PreviewWe appreciate Dr Mroueh’s comments raising the issue of using inhaled nitric oxide in the treatment of children presenting with severe acute asthma. We agree that nitric oxide appears to have some bronchodilator activity that may be additive to the use of beta agonists. Full-Text PDF