Therapeutic Role of Nitric Oxide in Respiratory Disease

Thomas E. Siddons, BSc, Mohammed Asif, MA, BMBCh, FRCS, and Tim W. Higenbottam, MD, MA, BSc, FRCP, University of Sheffield, Sheffield, United Kingdom

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Partial Liquid Ventilation With Inhaled NO

Partial liquid ventilation is known to improve lung function in conditions that involve surfactant deficiency, such as ARDS, and in underdeveloped, premature infants.[11] Perfluorocarbon liquids are characterized by low surface tensions and high densities. At atmospheric pressures, they are capable of carrying large amounts of oxygen and carbon dioxide. Replacement of the functional residual capacity with perfluorocarbon liquids reduces the observed increase in surface tension and resists alveolar collapse on expiration. This treatment has recently been combined with inhaled NO and has been shown to further augment the observed decrease in mean pulmonary artery pressure and the increase in PaO2 .[12] But what is not known is the extent to which NO dissolves in perfluorocarbon liquids and whether toxicity becomes an issue with dissolution. If NO does dissolve in the liquid or vapor phase, it will be susceptible to rapid oxidation, resulting in the formation of harmful redox species. Further investigation is necessary before these questions can be answered.

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