Cioffi W G, Ogura H
Department of Surgery, Brown University, Providence, RI, USA.
New Horiz. 1995 Feb;3(1):73-85.
The recognition that inhaled nitric oxide (NO.) selectively vasodilates the pulmonary vasculature and the fact that pulmonary artery hypertension appears to play a pivotal and central role in the clinical manifestations of adult respiratory distress syndrome have led to an explosion of interest in this treatment modality. Improved pulmonary function and reduced ventilatory support have been noted in some patients with acute lung disease treated with inhaled NO.. The efficacy of inhaled NO. in various animal models has been inconsistent. Although it appears likely that inhaled NO. will be a useful adjunct in the treatment of patients with acute lung disease, the appropriate role of inhaled NO. in the treatment of ARDS remains uncertain. In order for inhaled NO. to be clinically useful in patients, this modality will have to be combined with other treatments that alter the florid inflammatory response. One should anticipate the most benefit in patients in whom respiratory failure is secondary to pressure-driven pulmonary edema and true intrapulmonary shunt.
吸入一氧化氮（NO.）可选择性地使肺血管舒张，以及肺动脉高压似乎在成人呼吸窘迫综合征的临床表现中起关键核心作用这一认识，引发了人们对这种治疗方式的极大兴趣。在一些接受吸入NO.治疗的急性肺疾病患者中，已注意到肺功能改善且通气支持减少。吸入NO.在各种动物模型中的疗效并不一致。尽管吸入NO.似乎有可能成为治疗急性肺疾病患者的有用辅助手段，但吸入NO.在急性呼吸窘迫综合征（ARDS）治疗中的恰当作用仍不确定。为使吸入NO.在患者临床治疗中发挥作用，这种方式必须与其他改变剧烈炎症反应的治疗方法相结合。人们预计在呼吸衰竭继发于压力驱动型肺水肿和真正肺内分流的患者中获益最大。
