Inhaled nitric oxide and pulmonary vasoreactivity

Inhaled nitric oxide is a ubiquitous molecule which is produced endogenousl y and is also found in air pollution and in cigarette smoke. After describi ng the chemistry of NO, we review its history from the first description in 1980 to the current clinical indications. The biosynthesis of NO, its effe cts on pulmonary vasoreactivity, and the administration of inhaled NO will be described. The indications, uses, and side effects of inhaled NO are dis cussed with an emphasis on withdrawal of NO therapy, specifically the "rebo und" phenomenon. Possible drug interactions are listed. Inhaled nitric oxid e is here to stay, and future studies will provide more information on its therapeutic dose, duration and potential toxicity.