2-2--(hydroxynitrosohydrazono)bis-ethanamine and Respiratory-Distress-Syndrome

To examine the effects of inhaled NONOates in patients with acute respiratory distress syndrome (ARDS).. Case-series, phase I clinical trial.. A multidisciplinary intensive care unit in a tertiary teaching hospital.. Five consecutive patients with ARDS (men; age range, 47-76 years).. DETA/NO (150 micromol) was aerosolized into the lungs of patients on mechanical ventilation via the endotracheal tube over 20 minutes. Hemodynamic parameters were measured and blood samples were taken before, during, and after inhalation.. Compared to baseline values, pulmonary vascular resistance decreased until the end of the study period (180 minutes) while intrapulmonary shunting decreased significantly up to 45 min after DETA/NO aerosol administration. Inhaled DETA/NO had no effect on the systemic circulation (systemic blood pressure or cardiac output).. Inhaled DETA/NO is a selective pulmonary vasodilator in patients with ARDS. However, a larger number of patients is required to confirm the findings of this pilot study.

Topics: Administration, Inhalation; Aged; Hemodynamics; Humans; Intensive Care Units; Male; Middle Aged; Nitric Oxide Donors; Nitrites; Pilot Projects; Polyamines; Pulmonary Gas Exchange; Respiratory Distress Syndrome; Triazenes; Vasodilator Agents

To determine the selective vasodilatory effects of two inhaled "NONOate" aerosols in a closed chest pig model of acute pulmonary hypertension (APH).. APH was induced by IV infusion of the prostaglandin H(2)/thromboxane A(2) receptor agonist (U46619). Aerosolized diethylenetriamine nitric oxide (NO) adduct (DETA/NO, n = 4), dipropylenetriamine NO adduct (DPTA/NO, n = 4) [60 micro mol each], or placebo (n = 4) was delivered via the trachea. Hemodynamic parameters and blood samples were measured before and after inhalation therapy.. Compared to control animals, pulmonary vascular resistance and pulmonary arterial pressure were significantly reduced from 10 to 105 min after DETA/NO administration and from 10 to 45 min after DPTA/NO aerosol administration (p < 0.05). Both aerosols had no significant effect on systemic vascular resistance or systemic BP. Serum nitrite significantly increased after the inhalation of both NONOates (p < 0.01). There was a tendency for reduced intrapulmonary shunting, particularly after treatment with DETA/NO.. Both DETA/NO and DPTA/NO administered as aerosols selectively reduced pulmonary hypertension induced by U46619.

Topics: Aerosols; Alkenes; Analysis of Variance; Animals; Female; Hemodynamics; Hypertension, Pulmonary; Nitric Oxide Donors; Nitroso Compounds; Pulmonary Gas Exchange; Respiratory Distress Syndrome; Swine; Vasodilator Agents