Exhaled nitric oxide as a marker of lung injury in coronary artery bypass surgery.
Exhaled nitric oxide as a marker of lung injury in coronary artery bypass surgery.
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DOI：
10.1093/bja/90.1.101
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发表时间：
2003
影响因子：
9.8
通讯作者：
N. Marczin;T. Kövesi;D. Royston
中科院分区：
文献类型：
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作者：
N. Marczin;T. Kövesi;D. Royston
我们一直在进行类似的研究领域，并发表了一系列的观察，在这一领域的呼出一氧化氮和肺损伤的心脏手术和移植的设置在过去5年。2±9此外，Cuthbertson及其同事的工作似乎支持我们在社论中表达的观点：一氧化氮是肺损伤的介质、标记物和调节剂。[10]我们发现，Aberdeen小组的这篇潜在重要的文章包含了一些有趣的数据，需要进一步澄清。这在很大程度上与方法有关，因为方法似乎对获得的数据及其解释有重要影响。由于这在很大程度上归因于通气参数对呼出的一氧化氮浓度的影响，我们认为指出并在麻醉学界就呼出的一氧化氮研究的这一重要方面展开讨论是很重要的。问题的核心是报告的麻醉诱导后接受冠状动脉手术的患者呼出的一氧化氮水平的基线值（十亿分之一，ppb）。通过呼气末肺泡气体采样的方法获得的基线呼出一氧化氮浓度的中位数似乎接近60 ppb，然而，我们认为该值比正常人传导气道中获得的值高近10倍，比科学界认为的气相一氧化氮肺泡浓度高50±100倍。
We have been pursuing a similar area of research and published a series of observations in this field regarding exhaled nitric oxide and lung injury in the setting of heart surgery and transplantation during the last 5 yr. 2±9 In addition, the work of Cuthbertson and colleagues appears to support our opinions expressed in the editorial: nitric oxide as mediator, marker and modulator of lung injury. 10We find that the potentially important article by the Aberdeen group contains intriguing data that require further clarification. This is related largely to the methodology, which appears to have important effects on the data obtained and its interpretation. As this is largely attributable to influence of ventilation parameters on exhaled nitric oxide concentrations, we feel it important to point out and initiate discussions within the anaesthetic community on this important aspect of exhaled nitric oxide research. At the heart of the matter is the reported baseline value of exhaled nitric oxide levels (in parts per billion, ppb) in patients undergoing coronary surgery after induction of anaesthesia. The median of baseline exhaled nitric oxideÐobtained by a methodology thought to allow sampling of end-expiratory alveolar gasÐ appears to be close to 60 ppb However, we believe that this value is nearly 10-fold higher than that which has been obtained in normal human conducting airways, and 50±100 times greater than the scientific community believes are alveolar concentrations of gas phase nitric oxide.