HÜSEYİN ÇAKSEN, SELİM KURTOĞLU, AHMET ÇİFTÇİ
Turkish Archives of Pediatrics - 1997;32(4):19-26
Until recently, nitric oxide (NO) was best known as a constituent of carexhaust fumes, contributing to the photochemical smog of cities. In 1987 the demonstration that NO was formed in vascular endothelial cells opened up a vast area of research. Today NO is recognised as a major endogenous mediator of multiple physiological processes, including inhibition of platelet aggregation and mediation of the cytotoxic action of activated macrophages, and had a role in central and peripheral neurotransmission. NO's vasodilatory properties and short half life has led to the use of inhaled NO as a selective pulmonary vasodilator. Recently, exogenously administered NO gas has been utilized to treat infants with persistent pulmonary hypertension (PPH) of the newborn. These preliminary studies suggest that inhaled NO is a promising new therapy for the treatment of infants with PPH of the newborn. Controlled clinical trials must now be performed to determine if the use of inhaled NO improves the longterm outcome of patients with PPH of the newborn. Longterm exposure must be monitored closely for potential toxicity which includes methemoglobinemia and lung injury secondary to peroxynitrite and nitrogen dioxide production.
