ICU SAQs · Respiratory / ventilation
Inhaled pulmonary vasodilators — mechanism, use, and adverse effects
A CICM SAQ on inhaled pulmonary vasodilators — selective delivery, cyclic GMP versus cyclic AMP, the adult ARDS evidence, equivalence after major cardiac surgery, neonatal benefit, and the NO2, rebound and renal hazards.
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Prompt
Outline the mechanism, the evidence-based indications and the adverse effects of inhaled pulmonary vasodilators (inhaled nitric oxide and inhaled prostacyclin) in the ICU.
Question
Outline the mechanism, the evidence-based indications and the adverse effects of inhaled pulmonary vasodilators (inhaled nitric oxide and inhaled prostacyclin) in the ICU.[1]
References10ShowHide
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- [2]Weinberger B, Heck DE, Laskin DL, Laskin JD Nitric oxide in the lung: therapeutic and cellular mechanisms of action Pharmacol Ther, 1999.PMID 10665837
- [3]Knebel SM, Elrick MM, Bowles EA, et al. Synergistic effects of prostacyclin analogs and phosphodiesterase inhibitors on cyclic adenosine 3',5' monophosphate accumulation and adenosine 3'5' triphosphate release from human erythrocytes Exp Biol Med (Maywood), 2013.PMID 23986226
- [4]Gebistorf F, Karam O, Wetterslev J, et al. Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) in children and adults Cochrane Database Syst Rev, 2016.PMID 27347773
- [5]Hsu CW, Lee DL, Lin SL, Sun SF, Chang HW The initial response to inhaled nitric oxide treatment for intensive care unit patients with acute respiratory distress syndrome Respiration, 2008.PMID 17396026
- [6]Westfelt UN, Lundin S, Stenqvist O Safety aspects of delivery and monitoring of nitric oxide during mechanical ventilation Acta Anaesthesiol Scand, 1996.PMID 8721460
- [7]Namachivayam P, Theilen U, Butt WW, et al. Sildenafil prevents rebound pulmonary hypertension after withdrawal of nitric oxide in children Am J Respir Crit Care Med, 2006.PMID 16917115
- [8]Ghadimi K, Cappiello JL, Wright MC, et al. Inhaled Epoprostenol Compared With Nitric Oxide for Right Ventricular Support After Major Cardiac Surgery Circulation, 2023.PMID 37401479
- [9]Barrington KJ, Finer N, Pennaforte T, Altit G Nitric oxide for respiratory failure in infants born at or near term Cochrane Database Syst Rev, 2017.PMID 28056166
- [10]Bourg T, Bell CM, McMurray J, et al. Incidence of Methemoglobinemia in Cardiothoracic Surgery ICU Patients on Inhaled Nitric Oxide Ann Pharmacother, 2026.PMID 40542744