Outpatient inhaled nitric oxide in a patient with idiopathic pulmonary fibrosis: A bridge to lung transplantation

Inhaled nitric oxide (INO) has been shown to improve oxygenation and decrea se intrapulmonary shunt and pulmonary hypertension in various lung diseases . In this study we report a patient with end-stage idiopathic pulmonary fib rosis and pulmonary hypertension who received INO after coronary artery byp ass surgery, with significant improvement in arterial oxygenation and pulmo nary arterial pressure. Using a pulsing delivery system, the patient contin ued to receive outpatient INO for 30 months while waiting for lung transpla ntation. Exercise study and two-dimensional echocardiogram, after 3 months of inhaled NO, demonstrated continued benefits of INO for improvement of ar terial oxygenation, pulmonary arterial pressure and exercise tolerance.