Circulation, Vol 87, 447-453, Copyright © 1993 by American Heart Association
JD Roberts Jr, P Lang, LM Bigatello, GJ Vlahakes and WM Zapol
BACKGROUND. Congenital heart lesions may be complicated by pulmonary
arterial smooth muscle hyperplasia, hypertrophy, and hypertension. We
assessed whether inhaling low levels of nitric oxide (NO), an
endothelium-derived relaxing factor, would produce selective pulmonary
vasodilation in pediatric patients with congenital heart disease and
pulmonary hypertension. We also compared the pulmonary vasodilator
potencies of inhaled NO and oxygen in these patients. METHODS AND RESULTS.
In 10 sequentially presenting, spontaneously breathing patients, we
determined whether inhaling 20-80 ppm by volume of NO at inspired oxygen
concentrations (FIO2) of 0.21-0.3 and 0.9 would reduce the pulmonary
vascular resistance index (Rp). We then compared breathing oxygen with
inhaling NO. Inhaling 80 ppm NO at FIO2 0.21-0.3 reduced mean pulmonary
artery pressure from 48 +/- 19 to 40 +/- 14 mm Hg and Rp from 658 +/- 421
to 491 +/- 417 dyne.sec.cm-5.m-2 (mean +/- SD, both p < 0.05).
Increasing the FIO2 to 0.9 without adding NO did not reduce mean pulmonary
artery pressure but reduced Rp and increased the ratio of pulmonary to
systemic blood flow (Qp/Qs), primarily by increasing Qp (p < 0.05).
Breathing 80 ppm NO at FIO2 0.9 reduced mean pulmonary artery pressure and
Rp to the lowest levels and increased Qp and Qp/Qs (all p < 0.05). While
breathing at FIO2 0.9, inhalation of 40 ppm NO reduced Rp (p < 0.05);
the maximum reduction of Rp occurred while breathing 80 ppm NO. Inhaling 80
ppm NO at FIO2 0.21-0.9 did not alter mean aortic pressure or systemic
vascular resistance. Methemoglobin levels were unchanged by breathing up to
80 ppm NO for 30 minutes. CONCLUSIONS. Inhaled NO is a potent and selective
pulmonary vasodilator in pediatric patients with congenital heart disease
complicated by pulmonary artery hypertension. Inhaling low levels of NO may
provide an important and safe means for evaluating the pulmonary
vasodilatory capacity of patients with congenital heart disease without
producing systemic vasodilation.
ARTICLES
Inhaled nitric oxide in congenital heart disease
Department of Anesthesia, Harvard Medical School, Massachusetts General Hospital, Boston 02114.
This article has been cited by other articles:
 |
|
 |
|
  D. D. Ivy, A. K. Doran, K. J. Smith, G. B. Mallory Jr, M. Beghetti, R. J. Barst, D. Brady, Y. Law, D. Parker, L. Claussen, et al. Short- and Long-Term Effects of Inhaled Iloprost Therapy in Children With Pulmonary Arterial Hypertension J. Am. Coll. Cardiol., January 15, 2008; 51(2): 161 - 169. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. D. Bloch, F. Ichinose, J. D. Roberts Jr., and W. M. Zapol Inhaled NO as a therapeutic agent Cardiovasc Res, July 15, 2007; 75(2): 339 - 348. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Journois, C. Baufreton, P. Mauriat, P. Pouard, P. Vouhe, and D. Safran Effects of Inhaled Nitric Oxide Administration on Early Postoperative Mortality in Patients Operated for Correction of Atrioventricular Canal Defects Chest, November 1, 2005; 128(5): 3537 - 3544. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Morse and A. M. K. Choi Heme Oxygenase-1: From Bench to Bedside Am. J. Respir. Crit. Care Med., September 15, 2005; 172(6): 660 - 670. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Ichinose, J. D. Roberts Jr, and W. M. Zapol Inhaled Nitric Oxide: A Selective Pulmonary Vasodilator: Current Uses and Therapeutic Potential Circulation, June 29, 2004; 109(25): 3106 - 3111. [Full Text] [PDF]
|
|
|
|
|
|
S. Natori, N. Hasebe, Y.-T. Jin, T. Matsusaka, A. Ido, H. Matsuhashi, T. Ihara, and K. Kikuchi Inhaled Nitric Oxide Modifies Left Ventricular Diastolic Stress in the Presence of Vasoactive Agents in Heart Failure Am. J. Respir. Crit. Care Med., March 15, 2003; 167(6): 895 - 901. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Widlitz and R.J. Barst Pulmonary arterial hypertension in children Eur. Respir. J., January 1, 2003; 21(1): 155 - 176. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. T. Balzer, H. W. Kort, R. W. Day, H. M. Corneli, J. P. Kovalchin, B. C. Cannon, S. F. Kaine, D. D. Ivy, S. A. Webber, A. Rothman, et al. Inhaled Nitric Oxide as a Preoperative Test (INOP Test I): The INOP Test Study Group Circulation, September 24, 2002; 106(12_suppl_1): I-76 - I-81. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B.H. Jiang, J. Maruyama, A. Yokochi, H. Amano, Y. Mitani, and K. Maruyama Correlation of inhaled nitric-oxide induced reduction of pulmonary artery pressure and vascular changes Eur. Respir. J., July 1, 2002; 20(1): 52 - 58. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Baldauf, P. Silver, and M. Sagy Evaluating the Validity of Responsiveness to Inhaled Nitric Oxide in Pediatric Patients With ARDS : An Analytic Tool Chest, April 1, 2001; 119(4): 1166 - 1172. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Bushman Essentials of Nitric Oxide for the Pediatric (Cardiac) Anesthesiologist Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2001; 5(1): 79 - 90. [Abstract] [PDF]
|
|
|
|
|
|
P. C. Rimensberger, I. Spahr-Schopfer, M. Berner, E. Jaeggi, A. Kalangos, B. Friedli, and M. Beghetti Inhaled Nitric Oxide Versus Aerosolized Iloprost in Secondary Pulmonary Hypertension in Children With Congenital Heart Disease : Vasodilator Capacity and Cellular Mechanisms Circulation, January 30, 2001; 103(4): 544 - 548. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Nurozler, M. Argenziano, and M. E. Ginsburg Nitric oxide usage after posttraumatic pneumonectomy Ann. Thorac. Surg., January 1, 2001; 71(1): 364 - 366. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Krasuski, J. J. Warner, A. Wang, J. K. Harrison, V. F. Tapson, and T. M. Bashore Inhaled nitric oxide selectively dilates pulmonary vasculature in adult patients with pulmonary hypertension, irrespective of etiology J. Am. Coll. Cardiol., December 1, 2000; 36(7): 2204 - 2211. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Jaillard, Y. Riou, S. Klosowski, F. Cneude, P. Fialdes, X. Codaccioni, P. Lequien, and L. Storme Effects of inhaled nitric oxide on gas exchange and acute lung injury in premature lambs with moderate hyaline membrane disease Eur. J. Cardiothorac. Surg., September 1, 2000; 18(3): 334 - 341. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Roberts Jr, J.-D. Chiche, J. Weimann, W. Steudel, W. M. Zapol, and K. D. Bloch Nitric Oxide Inhalation Decreases Pulmonary Artery Remodeling in the Injured Lungs of Rat Pups Circ. Res., July 21, 2000; 87(2): 140 - 145. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. W. Day, J. A. Hawkins, E. C. McGough, K. L. Crezee, and G. S. Orsmond Randomized controlled study of inhaled nitric oxide after operation for congenital heart disease Ann. Thorac. Surg., June 1, 2000; 69(6): 1907 - 1912. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Hasuda, T. Satoh, A. Shimouchi, F. Sakamaki, S. Kyotani, T. Matsumoto, Y. Goto, and N. Nakanishi Improvement in Exercise Capacity With Nitric Oxide Inhalation in Patients With Precapillary Pulmonary Hypertension Circulation, May 2, 2000; 101(17): 2066 - 2070. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. S Hayward, R. P Kelly, and P. S Macdonald Inhaled nitric oxide in cardiology practice Cardiovasc Res, August 15, 1999; 43(3): 628 - 638. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Atz, I. Adatia, J. E. Lock, and D. L. Wessel Combined effects of nitric oxide and oxygen during acute pulmonary vasodilator testing J. Am. Coll. Cardiol., March 1, 1999; 33(3): 813 - 819. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Fortenberry, M. L. Owens, and L. A. S. Brown S-nitrosoglutathione enhances neutrophil DNA fragmentation and cell death Am J Physiol Lung Cell Mol Physiol, March 1, 1999; 276(3): L435 - L442. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Matsumoto, S.-i. Momomura, S. Sugiura, H. Fujita, T. Aoyagi, M. Sata, M. Omata, and Y. Hirata Effect of Inhaled Nitric Oxide on Gas Exchange in Patients with Congestive Heart Failure: A Randomized, Controlled Trial Ann Intern Med, January 5, 1999; 130(1): 40 - 44. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J R Beck, L B Mongero, R M Kroslowitz, A F Choudhri, J M Chen, J J DeRose, M Argenziano, A J Smerling, and M C Oz Inhaled nitric oxide improves hemodynamics in patients with acute pulmonary hypertension after high-risk cardiac surgery Perfusion, January 1, 1999; 14(1): 37 - 42. [Abstract] [PDF]
|
|
|
|
 |
|
 S. Ishihara, J. A. Ward, O. Tasaki, B. A. Pruitt Jr., C. W. Goodwin Jr., D. W. Mozingo, and W. G. Cioffi Jr. Inhaled nitric oxide prevents left ventricular impairment during endotoxemia J Appl Physiol, December 1, 1998; 85(6): 2018 - 2024. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. I. Hermo-Weiler, T. Koizumi, R. Parker, and J. H. Newman Pulmonary vasoconstriction induced by mitral valve obstruction in sheep J Appl Physiol, November 1, 1998; 85(5): 1655 - 1660. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. W. ZIEGLER, D. D. IVY, J. W. WIGGINS, J. P. KINSELLA, W. R. CLARKE, and S. H. ABMAN Effects of Dipyridamole and Inhaled Nitric Oxide in Pediatric Patients with Pulmonary Hypertension Am. J. Respir. Crit. Care Med., November 1, 1998; 158(5): 1388 - 1395. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. F. Tang, M. C Sherwood, and O. I Miller Randomised trial of three doses of inhaled nitric oxide in acute respiratory distress syndrome Arch. Dis. Child., November 1, 1998; 79(5): 415 - 418. [Abstract] [Full Text]
|
|
|
|
|
|
G. F. ZHU, B. SUN, S. F. NIU, Y. Y. CAI, K. LIN, R. LINDWALL, and B. ROBERTSON Combined Surfactant Therapy and Inhaled Nitric Oxide in Rabbits with Oleic Acid-induced Acute Respiratory Distress Syndrome Am. J. Respir. Crit. Care Med., August 1, 1998; 158(2): 437 - 443. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. D. Ivy, J. P. Kinsella, J. W. Ziegler, and S. H. Abman Dipyridamole attenuates rebound pulmonary hypertension after inhaled nitric oxide withdrawal in postoperative congenital heart disease J. Thorac. Cardiovasc. Surg., April 1, 1998; 115(4): 875 - 882. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Argenziano, D. A. Dean, N. Moazami, D. J. Goldstein, E. A. Rose, H. M. Spotnitz, D. Burkhoff, M. C. Oz, and M. L. Dickstein Inhaled Nitric Oxide Is Not A Myocardial Depressant In A Porcine Model Of Heart Failure J. Thorac. Cardiovasc. Surg., March 1, 1998; 115(3): 700 - 704. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Fortenberry, M. L. Owens, M. R. Brown, D. Atkinson, and L. A. S. Brown Exogenous Nitric Oxide Enhances Neutrophil Cell Death and DNA Fragmentation Am. J. Respir. Cell Mol. Biol., March 1, 1998; 18(3): 421 - 428. [Abstract] [Full Text]
|
|
|
|
|
|
M. Argenziano, A. F. Choudhri, N. Moazami, E. A. Rose, C. R. Smith, H. R. Levin, A. J. Smerling, and M. C. Oz Randomized, Double-Blind Trial of Inhaled Nitric Oxide in LVAD Recipients With Pulmonary Hypertension Ann. Thorac. Surg., February 1, 1998; 65(2): 340 - 345. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M I Turanlahti, P O Laitinen, S J Sarna, and E Pesonen Nitric oxide, oxygen, and prostacyclin in children with pulmonary hypertension Heart, February 1, 1998; 79(2): 169 - 174. [Abstract] [Full Text]
|
|
|
|
 |
|
 Y. Takahashi, H. Kobayashi, N. Tanaka, T. Sato, N. Takizawa, and T. Tomita Nitrosyl hemoglobin in blood of normoxic and hypoxic sheep during nitric oxide inhalation Am J Physiol Heart Circ Physiol, January 1, 1998; 274(1): H349 - H357. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Brilli, B. Krafte-Jacobs, D. J. Smith, D. Roselle, D. Passerini, A. Vromen, L. Moore, C. Szabo, and A. L. Salzman Intratracheal instillation of a novel NO/nucleophile adduct selectively reduces pulmonary hypertension J Appl Physiol, December 1, 1997; 83(6): 1968 - 1975. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. MOURGEON, E. LEVESQUE, C. DUVEAU, J.-D. LAW-KOUNE, B. CHARBIT, E. TERNISSIEN, P. CORIAT, and J.-J. ROUBY Factors Influencing Indoor Concentrations of Nitric Oxide in a Parisian Intensive Care Unit Am. J. Respir. Crit. Care Med., November 1, 1997; 156(5): 1692 - 1695. [Abstract] [Full Text]
|
|
|
|
 |
|
 D. L. Wessel, I. Adatia, L. J. Van Marter, J. E. Thompson, J. W. Kane, A. R. Stark, and S. Kourembanas Improved Oxygenation in a Randomized Trial of Inhaled Nitric Oxide for Persistent Pulmonary Hypertension of the Newborn Pediatrics, November 1, 1997; 100(5): e7 - e7. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N V Subhedar and N J Shaw Changes in oxygenation and pulmonary haemodynamics in preterm infants treated with inhaled nitric oxide Arch. Dis. Child. Fetal Neonatal Ed., November 1, 1997; 77(3): 191F - 197. [Abstract] [Full Text]
|
|
|
|
|
|
N. FINER Inhaled nitric oxide in neonates Arch. Dis. Child. Fetal Neonatal Ed., September 1, 1997; 77(2): 81F - 84. [Full Text]
|
|
|
|
|
|
N. D. Hillman, I. M. Cheifetz, D. M. Craig, P. K. Smith, R. M. Ungerleider, and J. N. Meliones INHALED NITRIC OXIDE, RIGHT VENTRICULAR EFFICIENCY, AND PULMONARY VASCULAR MECHANICS: SELECTIVE VASODILATION OF SMALL PULMONARY VESSELS DURING HYPOXIC PULMONARY VASOCONSTRICTION J. Thorac. Cardiovasc. Surg., June 1, 1997; 113(6): 1006 - 1013. [Abstract] [Full Text]
|
|
|
|
|
|
R. Mathew, E. S. Gloster, T. Sundararajan, C. I. Thompson, G. A. Zeballos, and M. H. Gewitz Role of inhibition of nitric oxide production in monocrotaline-induced pulmonary hypertension J Appl Physiol, May 1, 1997; 82(5): 1493 - 1498. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. P. Chen, H. B. Bittner, F. Tull, D. Craig, R. D. Davis, and P. Van Trigt NITRIC OXIDE IMPROVES PULMONARY VASCULAR IMPEDANCE, TRANSPULMONARY EFFICIENCY, AND LEFT VENTRICULAR FILLING IN CHRONIC PULMONARY HYPERTENSION J. Thorac. Cardiovasc. Surg., May 1, 1997; 113(5): 849 - 857. [Abstract] [Full Text]
|
|
|
|
|
|
A. Gamillscheg, G. Zobel, B. Urlesberger, J. Berger, D. Dacar, J. I. Stein, B. Rigler, H. Metzler, and A. Beitzke INHALED NITRIC OXIDE IN PATIENTS WITH CRITICAL PULMONARY PERFUSION AFTER FONTAN-TYPE PROCEDURES AND BIDIRECTIONAL GLENN ANASTOMOSIS J. Thorac. Cardiovasc. Surg., March 1, 1997; 113(3): 435 - 442. [Abstract] [Full Text]
|
|
|
|
 |
|
 J. D. Roberts, J. R. Fineman, F. C. Morin, P. W. Shaul, S. Rimar, M. D. Schreiber, R. A. Polin, M. S. Zwass, M. M. Zayek, I. Gross, et al. Inhaled Nitric Oxide and Persistent Pulmonary Hypertension of the Newborn N. Engl. J. Med., February 27, 1997; 336(9): 605 - 610. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. G. S. Emil, J. E. Berkeland, and J. B. Atkinson Nitric Oxide Dose Response During Moderate and Severe Hypoxia in Swine Ann. Thorac. Surg., February 1, 1997; 63(2): 414 - 418. [Abstract] [Full Text]
|
|
|
|
|
|
A. M. Atz, I. Adatia, and D. L. Wessel Rebound Pulmonary Hypertension After Inhalation of Nitric Oxide Ann. Thorac. Surg., December 1, 1996; 62(6): 1759 - 1764. [Abstract] [Full Text]
|
|
|
|
|
|
M. B. Pitton, C. Duber, E. Mayer, and M. Thelen Hemodynamic Effects of Nonionic Contrast Bolus Injection and Oxygen Inhalation During Pulmonary Angiography in Patients With Chronic Major-Vessel Thromboembolic Pulmonary Hypertension Circulation, November 15, 1996; 94(10): 2485 - 2491. [Abstract] [Full Text]
|
|
|
|
|
|
A. P. Goldman, R. E. Delius, J. E. Deanfield, M. R. de Leval, P. E. Sigston, and D. J. Macrae Nitric Oxide Might Reduce the Need for Extracorporeal Support in Children With Critical Postoperative Pulmonary Hypertension Ann. Thorac. Surg., September 1, 1996; 62(3): 750 - 755. [Abstract] [Full Text]
|
|
|
|
|
|
V. M. Reddy, J. R. Liddicoat, J. R. Fineman, D. B. McElhinney, J. R. Klein, and F. L. Hanley FETAL MODEL OF SINGLE VENTRICLE PHYSIOLOGY: HEMODYNAMIC EFFECTS OF OXYGEN, NITRIC OXIDE, CARBON DIOXIDE, AND HYPOXIA IN THE EARLY POSTNATAL PERIOD J. Thorac. Cardiovasc. Surg., August 1, 1996; 112(2): 437 - 449. [Abstract] [Full Text]
|
|
|
|
|
|
A. P. Goldman, S. G. Haworth, and D. J. Macrae DOES INHALED NITRIC OXIDE SUPPRESS ENDOGENOUS NITRIC OXIDE PRODUCTION? J. Thorac. Cardiovasc. Surg., August 1, 1996; 112(2): 541 - 542. [Full Text]
|
|
|
|
|
|
D.J. Williamson, C. Hayward, P. Rogers, L.L. Wallman, A.D. Sturgess, R. Penny, and P.S. Macdonald Acute Hemodynamic Responses to Inhaled Nitric Oxide in Patients With Limited Scleroderma and Isolated Pulmonary Hypertension Circulation, August 1, 1996; 94(3): 477 - 482. [Abstract] [Full Text]
|
|
|
|
|
|
D. A. Fullerton and R. C. McIntyre Jr Inhaled Nitric Oxide: Therapeutic Applications in Cardiothoracic Surgery Ann. Thorac. Surg., June 1, 1996; 61(6): 1856 - 1864. [Abstract] [Full Text]
|
|
|
|
|
|
D. A. Fullerton, S. D. Jones, J. Jaggers, F. Piedalue, RRT, F. L. Grover, and R. C. McIntyre Jr. EFFECTIVE CONTROL OF PULMONARY VASCULAR RESISTANCE WITH INHALED NITRIC OXIDE AFTER CARDIAC OPERATION J. Thorac. Cardiovasc. Surg., April 1, 1996; 111(4): 753 - 763. [Abstract] [Full Text]
|
|
|
|
|
|
J. S. Lee, C. Adrie, H. J. Jacob, J. D. Roberts Jr, W. M. Zapol, and K. D. Bloch Chronic Inhalation of Nitric Oxide Inhibits Neointimal Formation After Balloon-Induced Arterial Injury Circ. Res., February 1, 1996; 78(2): 337 - 342. [Abstract] [Full Text]
|
|
|
|
 |
|
 W. J. Fulkerson, N. MacIntyre, J. Stamler, and J. D. Crapo Pathogenesis and Treatment of the Adult Respiratory Distress Syndrome Arch Intern Med, January 8, 1996; 156(1): 29 - 38. [Abstract] [PDF]
|
|
|
|
|
|
D. A. Fullerton, M. B. Mitchell, D. N. Jones, A. Maki, and R. C. McIntyre Jr. PULMONARY VASOMOTOR DYSFUNCTION IS PRODUCED WITH CHRONICALLY HIGH PULMONARY BLOOD FLOW J. Thorac. Cardiovasc. Surg., January 1, 1996; 111(1): 190 - 197. [Abstract] [Full Text]
|
|
|
|
|
|
R. D. Curran, C. Mavroudis, C. L. Backer, M. Sautel, V. R. Zales, and D. L. Wessel Inhaled Nitric Oxide for Children With Congenital Heart Disease and Pulmonary Hypertension Ann. Thorac. Surg., December 1, 1995; 60(6): 1765 - 1771. [Abstract] [Full Text]
|
|
|
|
|
|
N. D. Hillman, J. N. Meliones, D. R. Black, D. M. Craig, I. M. Cheifetz, and P. K. Smith In acute lung injury, inhaled nitric oxide improves ventilation-perfusion matching, pulmonary vascular mechanics, and transpulmonary vascular efficiency J. Thorac. Cardiovasc. Surg., September 1, 1995; 110(3): 593 - 600. [Abstract] [Full Text]
|
|
|
|
|
|
A. P. Goldman, R. E. Delius, J. E. Deanfield, and D. J. Macrae Nitric Oxide Is Superior to Prostacyclin for Pulmonary Hypertension After Cardiac Operations Ann. Thorac. Surg., August 1, 1995; 60(2): 300 - 305. [Abstract] [Full Text]
|
|
|
|
|
|
S. K. Schachtner, J. J. Rome, R. F. Hoyt Jr, K. D. Newman, R. Virmani, and D. A. Dichek In Vivo Adenovirus-Mediated Gene Transfer Via the Pulmonary Artery of Rats Circ. Res., May 1, 1995; 76(5): 701 - 709. [Abstract] [Full Text]
|
|
|
|
 |
|
 H. Ogura, P. J. Offner, D. Saitoh, B. S. Jordan, A. A. Johnson, B. A. Pruitt Jr, and W. G. Cioffi Jr The Pulmonary Effect of Nitric Oxide Synthase Inhibition Following Endotoxemia in a Swine Model Arch Surg, December 1, 1994; 129(12): 1233 - 1239. [Abstract] [PDF]
|
|
|
|
|
|
O. I. Miller, D. S. Celermajer, J. E. Deanfield, and D. J. Macrae Very-low-dose inhaled nitric oxide: A selective pulmonary vasodilator after operations for congenital heart disease J. Thorac. Cardiovasc. Surg., September 1, 1994; 108(3): 487 - 494. [Abstract] [Full Text]
|
|
|
|
|
|
R. L. Geggel and E. J. Mark Case 37-1993- A 48-Year-Old Woman with an Atrial Septal Defect and Pulmonary Hypertension N. Engl. J. Med., September 16, 1993; 329(12): 864 - 872. [Full Text]
|
|