INHALED NITRIC OXIDE FOR TREATMENT OF NEONATAL & ADULT PULMONARY HYPE

本研究的目的是获得经验，在管理一氧化氮（NO）的患者与传统治疗抵抗严重肺动脉高压，并制定标准，预测的可能性，患者从吸入NO受益。患者将接受NO将呼吸机依赖。 由于NO在空气或氧气中不稳定，因此必须在吸入前与空气接触仅几秒钟的位置将其添加到吸入气体中。 将NO施用到吸入气体的过程将自然地受到通气机、通气模式和通过通气机的总气流的力学的影响。此外，机械通气的行为将影响患者的肺和血液动力学生理。 基于预测该通气模式的肺和血液动力学效应以及患者的个体病理生理学，在个体患者中选择不同的机械通气模式。 吸入气体中添加NO可能会影响患者对各种通气模式的反应。本研究将以纵向方式使用患者作为其自身对照，仅考虑NO是否有效降低肺动脉压或重新分配肺血流，从而改善动脉血氧饱和度和/或减少肺分流。吸入NO的功效将与患者疾病的性质和严重程度、患者正在接受的呼吸支持的类型以及患者正在接受的任何伴随治疗相关。

The purpose of this study is to gain experience in administering nitric oxide (NO) to patients with critical pulmonary hypertension resistant to conventional therapy, and to develop criteria for predicting the likelihood of a patient deriving benefit from inhaled NO. Patients who will receive NO will be ventilator-dependent. Since NO in unstable in air or oxygen, it must be added to the inspired gas at a point where it is in contact with air for only a few seconds before being inhaled. The process of administering the NO to the inspiratory gas will naturally be affected by the ventilator, the mode of ventilation, and the mechanics of the total gas flow through the ventilator. Additionally, the act of mechanical ventilation will affect the pulmonary and hemodynamic physiology of the patient. Different modes of mechanical ventilation are selected in individual patients based on predicting pulmonary and hemodynamic effects of that mode of ventilation and the patients' individual pathophysiology. Addition of NO to the inspired gases may have an impact upon the patients' response to various modes of ventilation. This investigation will use patients as their own controls in a longitudinal fashion and will consider only whether NO is effective in lowering the pulmonary artery pressure, or in redistribution pulmonary blood flow so that arterial oxygen saturation is improved and/or pulmonary shunt decreased. Efficacy of inhaled NO will be correlated with the nature and severity of the patient's disease, the type of respiratory support the patient is receiving, and whatever concomitant therapy the patient is receiving.