NITRIC-OXIDE DOES NOT REVERSE PULMONARY-HYPERTENSION ASSOCIATED WITH END-STAGE LIVER-DISEASE - A PRELIMINARY-REPORT

Citation
Mae. Ramsay et al., NITRIC-OXIDE DOES NOT REVERSE PULMONARY-HYPERTENSION ASSOCIATED WITH END-STAGE LIVER-DISEASE - A PRELIMINARY-REPORT, Hepatology, 25(3), 1997, pp. 524-527
Citations number
19
Categorie Soggetti
Gastroenterology & Hepatology
Journal title
ISSN journal
02709139
Volume
25
Issue
3
Year of publication
1997
Pages
524 - 527
Database
ISI
SICI code
0270-9139(1997)25:3<524:NDNRPA>2.0.ZU;2-V
Abstract
Pulmonary hypertension is a well known, though uncommon complication o f end-stage liver disease (ESLD). Patients with severe pulmonary hyper tension and ESLD undergoing orthotopic liver transplantation (OLT) may develop right ventricular failure and death. This study investigates the reversibility of pulmonary hypertension by the inhalation of nitri c oxide in patients under evaluation for OLT. Ten patients with ESLD w ho were discovered to have moderate to severe pulmonary hypertension w ere administered nitric oxide via face mask in concentrations ranging from 0 to 80 ppm. Inhaled nitric oxide is a potent pulmonary vasodilat or without apparent systemic effects. Nitric oxide had no demonstrable effect on mean pulmonary artery pressure (PAP) (37 vs. 37 mm Hg), tra nspulmonary gradient (TPG) (26 vs. 26 mm Hg), or pulmonary vascular re sistance (PVR) (295 vs. 288 dynes . sec . cm(-5)). Two patients were d iscovered to have an elevated pulmonary artery occlusion pressure (PAO P) on baseline readings. The cause of pulmonary hypertension in these two patients was secondary to volume overload as a result of hepato-re nal syndrome rather than primary pulmonary arteriolar pathology and wa s responsive to diuresis or dialysis but not to nitric oxide therapy. In conclusion nitric oxide does not reverse pulmonary hypertension ass ociated with ESLD.