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UTILIZAÇAO DO OXIDO NITRICO INALADO EM CIRURGIA CARDIOTORACICA E NA INSUFICIENCIA CARDIACA. UMA REVISAO CRITICA DA LITERATURA

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Na ausência de ensaios envolvendo grande número de pacientes, e, apesar de seu potencial tóxico, o NO inalado deve ser utilizado com extremo rigor técnico, como uma prova terapêutica que pode salvar vidas
evora9.jpg Autor:
Barbosa evora, paulo roberto
Columnista Experto de SIIC

Institución:
Facultad de Medicina de Ribeirão Preto Universidad de São Paulo SP, Brasil

Artículos publicados por Barbosa evora, paulo roberto
Coautores
Fernanda Viaro*  Alfredo J. Rodrigues**  Walter Vilella A. Vicente*** 
Mestre em Cirurgia (Cirurgia Experimental). Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo*
Professor Doutor. Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo**
Professor Associado. Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo***
Recepción del artículo
29 de Octubre, 2004 		Aprobación
22 de Noviembre, 2004
Primera edición
31 de Marzo, 2005 		Segunda edición, ampliada y corregida
7 de Junio, 2021

UTILIZAÇAO DO OXIDO NITRICO INALADO EM CIRURGIA CARDIOTORACICA E NA INSUFICIENCIA CARDIACA. UMA REVISAO CRITICA DA LITERATURA

Resumen
Objetivo: Apresentar uma revisão e análise crítica sobre a utilização do óxido nítrico (NO) pela via inalatória em cirurgia cardíaca. Método: metanálise de artigos publicados e inseridos no banco de dados Medline da National Library of Medicine dos Estados Unidos da América. Foram enfatizados aspectos da biologia do NO, mecanismos de ação seletiva do NO pela via inalatória, aspectos técnicos e éticos, aplicações clínicas em cirurgia cardíaca, além de uma análise crítica procurando demonstrar a atual posição da utilização do NO pela via inalatória. Resultado: As principais evidências foram: a) O NO inalado é reconhecido, atualmente, como um valioso recurso farmacológico da medicina intensiva neonatal e pediátrica, e para a cirurgia cardiopulmonar; b) Outras aplicações em adultos, como a doença pulmonar obstrutiva crônica e a síndrome da angústia respiratória do adulto, necessitam de cuidadosa observação; c) A terapêutica com o NO inalado é relativamente barata, mas não deve ser utilizada em todos os pacientes, com base nos paradigmas de sua eficiência e potencial toxicidade; d) As recentes descobertas de seus efeitos antiinflamatórios e extrapulmonares abrem novos horizontes para futuras aplicações. Conclusão: Embora seja evidente a extrema variabilidade da resposta vasodilatadora pulmonar seletiva do NO inalado, serviços que tratam pacientes portadores de distúrbios respiratórios, principalmente associados à hipertensão pulmonar, devem dispor do NO inalado como recurso terapêutico. Na ausência de ensaios envolvendo grande número de pacientes, e, apesar de seu potencial tóxico, o NO inalado deve ser utilizado com extremo rigor técnico, como uma prova terapêutica que pode salvar vidas.

Palabras clave
Óxido nítrico, uso terapêutico, hipertensão pulmonar, procedimentos cirúrgicos cardíacos


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Especialidades
Principal: 
Relacionadas: Bioquímica, Cirugía, Cuidados Intensivos, Farmacología, Medicina Interna, Neumonología



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Bibliografía del artículo
  1. Furchgott RF & Zawadzki JV. The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature 1980; 288: 373-6.
  2. Cherry PD, Furchgott RF, Zawadzki JV, Jothianandan D. Role of endothelial cells in relaxation of isolated arteries by bradykinin. Proc Natl Acad Sci USA 1982; 79:2106-10.
  3. Cocks T & Angus JA. Bioassay of the release of endothelium-derived relaxing factor (EDRF) from isolated endothelial cells in vitro. In: Bevan JA, Godfraind T, Maxwell RA, Stoclet JS, Worcel M, eds. Vascular neuroeffector mechanisms. Amsterdam: Elsevier, 1985:131-6.
  4. Furchgott RF. Studies on relaxation of rabbit aorta by sodium nitrite: the basis for the proposal that the acid-activated inhibitory factor from bovine retractor penis is inorganic nitrite and the endothelium-derived relaxing factor is nitric oxide. In: Vanhoutte PM, ed. Mechanisms of vasodilatation. New York: Raven Press, 1988:401-14. vol. IV.
  5. Ignarro LJ, Byrns RE, Wood KS. Biochemical and pharmacological properties of EDRF and its similarity to nitric oxide radical. In: Vanhoutte PM , ed. Mechanisms of vasodilatation. New York: Raven Press, 1988:427-35. vol. IV.
  6. Palmer RM, Ferrige AG, Moncada S. Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor. Nature 1987; 327:524-6.
  7. Palmer RM, Ashton DS, Moncada S. Vascular endothelial cells synthesize nitric oxide from L-arginine. Nature 1988; 333:664-6.
  8. Frostell C, Fratacci MD, Wain JC, Jones R, Zapol WM. Inhaled nitric oxide: a selective pulmonary vasodilator reversing hypoxic pulmonary vasoconstriction. Circulation 1991; 83:2038-47.
  9. Moncada S, Palmer RM, Higgs EA. Nitric oxide: physiology, pathophysiology, and pharmacology. Pharmacol Rev 1991; 43:109-42.
  10. Snyder SH & Bredt DS. Biological roles of nitric oxide. Sci Am 1992; 266:68-77.
  11. Tavares AP, Pimenta Junior AG, Evora PR. Basis for the therapeutic use of inhaled nitric oxide. Arq Bras Cardiol 1995; 64:45-52.
  12. Frostell CG, Blomqvist H, Hedenstierna G, Lundberg J, Zapol WM. Inhaled nitric oxide selectively reverses human hypoxic pulmonary vasoconstriction without causing systemic vasodilation. Anesthesiology 1993; 78:427-35.
  13. Wessel DL, Adatia I, Giglia TM, Thompson JE, Kulik TJ. Use of inhaled nitric oxide and acetylcholine in the evaluation of pulmonary hypertension and endothelial function after cardiopulmonary bypass. Circulation 1993; 88(5 pt 1), 2128-38.
  14. Roberts Jr. JD, Lang P, Bigatello LM, Vlahakes GJ, Zapol WM. Inhaled nitric oxide in congenital heart disease. Circulation 1993; 87:447-53.
  15. Vallance P, Collier J, Moncada S. Effects of endothelium-derived nitric oxide on peripheral arteriolar tone in man. Lancet 1989; 2:997-1000.
  16. Cremona G, Dinh-Xuan AT, Higenbottam TW. Endothelium-derived relaxing factor and the pulmonary circulation. Lung 1991; 169:185-202.
  17. Roos CM, Rich GF, Uncles DR, Daugherty MO, Frank DU. Sites of vasodilation by inhaled nitric oxide vs. sodium nitroprusside in endothelin-constricted isolated rat lungs. J Appl Physiol 1994; 77:51-7.
  18. Benzing A & Geiger K. Inhaled nitric oxide lowers pulmonary capillary pressure and changes longitudinal distribution of pulmonary vascular resistance in patients with acute lung injury. Acta Anaesthesiol Scand 1994; 38:640-5.
  19. Carmona MJ & Auler Jr. JO. Effects of inhaled nitric oxide on respiratory system mechanics, hemodynamics, and gas exchange after cardiac surgery. J Cardiothorac Vasc Anesth 1998; 12:157-61.
  20. Centers for Disease Control. Recommendation for occupational safety and health standard. MMWR Morb Mortal WKLY Rep 1980; 37:S7.
  21. Atz AM & Wessel DL. Inhaled nitric oxide in the neonate with cardiac disease. Semin Perinatol 1997; 21:441-55.
  22. Miller OI, Tang SF, Keech A, Pigott NB, Beller E, Celermajer DS. Inhaled nitric oxide and prevention of pulmonary hypertension after congenital heart surgery: a randomised double-blind study. Lancet 2000; 356:1464-9.
  23. Day RW, Hawkins JA, McGough EC, Crezee KL, Orsmond GS. Randomized controlled study of inhaled nitric oxide after operation for congenital heart disease. Ann Thorac Surg 2000; 69:1907-13.
  24. Russell IA, Zwass MS, Fineman JR et al. The effects of inhaled nitric oxide on postoperative pulmonary hypertension in infants and children undergoing surgical repair of congenital heart disease. Anesth Analg 1998; 87:46-51.
  25. Beghetti M, Morris K, Cox P, Bohn D, Adatia I. Inhaled nitric oxide differentiates pulmonary vasospasm from vascular obstruction after surgery for congenital heart disease. Intensive Care Med 1999; 25:1126-30.
  26. Wessel DL & Adatia I. Clinical applications of inhaled nitric oxide in children with pulmonary hypertension. Adv Pharmacol 1995; 34:475-504.
  27. Schulze-Neick I, Bultmann M, Werner H et al. Right ventricular function in patients treated with inhaled nitric oxide after cardiac surgery for congenital heart disease in newborns and children. Am J Cardiol 1997; 80:360-3.
  28. Solina A, Papp D, Ginsberg S et al. A comparison of inhaled nitric oxide and milrinone for the treatment of pulmonary hypertension in adult cardiac surgery patients. J Cardiothorac Vasc Anesth 2000; 14:12-7.
  29. Schmid ER, Burki C, Engel MH, Schmidlin D, Tornic M, Seifert B. Inhaled nitric oxide versus intravenous vasodilators in severe pulmonary hypertension after cardiac surgery. Anesth Analg 1999; 89:1108-15.
  30. Bando K, Konishi H, Komatsu K et al. Improved survival following pediatric cardiac transplantation in high-risk patients. Circulation 1993; 88(5 Pt 2):II218-23.
  31. Murali S, Kormos RL, Uretsky BF et al. Preoperative pulmonary hemodynamics and early mortality after orthotopic cardiac transplantation: the Pittsburgh experience. Am Heart J 1993; 126:896-904.
  32. Kieler-Jensen N, Lundin S, Ricksten S. Vasodilator therapy after heart transplantation: effects of inhaled nitric oxide and intravenous prostacyclin, prostaglandin E1, and sodium nitroprusside. J Heart Lung Transplant 1995; 14:436-43.
  33. Williams TJ, Salamonsen RF, Snell G, Kaye D, Esmore DS. Preliminary experience with inhaled nitric oxide for acute pulmonary hypertension after heart transplantation. J Heart Lung Transplant 1995; 14:419-23.
  34. Girard C, Durand PG, Vedrinne C et al. Inhaled nitric oxide for right ventricular failure after heart transplantation. J Cardiothorac Vasc Anesth 1993; 7:481-5.
  35. Auler Jr. JO, Carmona MJ, Bocchi EA et al. Low doses of inhaled nitric oxide in heart transplant recipients. J Heart Lung Transplant 1996, 15:443-50.
  36. Troncy E, Francoeur M, Blaise G. Inhaled nitric oxide: clinical applications, indications, and toxicology. Can J Anaesth 1997; 44:973-88.
  37. Morris K, Beghetti M, Petros A, Adatia I, Bohn D. Comparison of hyperventilation and inhaled nitric oxide for pulmonary hypertension after repair of congenital heart disease. Crit Care Med 2000; 28:2974-8.
  38. Allman KG, Young JD, Carapiet D, Stevens JE, Ostman-Smith I, Archer LN. Effects of oxygen and nitric oxide in oxygen on pulmonary arterial pressures of children with congenital cardiac defects. Pediatr Cardiol 1996; 17:246-50.
  39. Sharma R, Raizada N, Choudhary SK et al. Does inhaled nitric oxide improve survival in operated congenital disease with severe pulmonary hypertension Indian Heart J 2001; 53:48-55.
  40. Curran RD, Mavroudis C, Backer CL, Sautel M, Zales VR, Wessel DL. Inhaled nitric oxide for children with congenital heart disease and pulmonary hypertension. Ann Thorac Surg 1995; 60:1765-71.
  41. Laitinen PO, Rasanen J, Sairanen H. Postoperative nitric oxide therapy in children with congenital heart disease: can the need be predicted Scand Cardiovasc J 2000; 34:149-53.
  42. Rimensberger PC, Spahr-Schopfer I, Berner M et al. Inhaled nitric oxide versus aerosolized iloprost in secondary pulmonary hypertension in children with congenital heart disease: vasodilator capacity and cellular mechanisms. Circulation 2001; 103:544-8.
  43. Ichida F, Uese K, Hashimoto I et al. Acute effect of oral prostacyclin and inhaled nitric oxide on pulmonary hypertension in children. J Cardiol 1997; 29:217-24.
  44. Ivy DD, Kinsella JP, Ziegler JW, Abman SH. Dipyridamole attenuates rebound pulmonary hypertension after inhaled nitric oxide withdrawal in postoperative congenital heart disease. J Thorac Cardiovasc Surg 1998;115:875-82.
  45. Yahagi N, Kumon K, Tanigami H et al. Cardiac surgery and inhaled nitric oxide: indication and follow-up (2-4 years). Artif Organs 1998; 22:886-91.
  46. Atz AM & Wessel DL. Nitric oxide inhalation. In: Rubanyi GM, ed. Pathophysiology and clinical applications of nitric oxide. Netherlands: Harwood Academic Publishers, 1999; 471-503.
  47. Omar HA, Gong F, Sun MY, Einzig S. Nebulized nitroglycerin in children with pulmonary hypertension secondary to congenital heart disease. W V Med J 1999; 95:74-5.
  48. Hayward CS, Kalnins WV, Rogers P, Feneley MP, Macdonald PS, Kelly RP. Left ventricular chamber function during inhaled nitric oxide in patients with dilated cardiomyopathy. J Cardiovasc Pharmacol. 1999; 34:749-54.
  49. Hare JM, Shernan SK, Body SC, Graydon E, Colucci WS, Couper GS. Influence of inhaled nitric oxide on systemic flow and ventricular filling pressure in patients receiving mechanical circulatory assistance. Circulation. 1997 6;95:2250-3.
  50. Loh E, Lankford EB, Polidori DJ, Doering-Lubit EB, Hanson CW, Acker MA. Cardiovascular effects of inhaled nitric oxide in a canine model of cardiomyopathy.Ann Thorac Surg. 1999;67:1380-5.
  51. Bocchi EA, Bacal F, Auler Junior JO, Carmone MJ, Bellotti G, Pileggi F. Inhaled nitric oxide leading to pulmonary edema in stable severe heart failure. Am J Cardiol. 1994; 74:70-2.
  52. Hayward CS, Rogers P, Keogh AM, Kelly R, Spratt PM, Macdonald PS. Inhaled nitric oxide in cardiac failure: vascular versus ventricular effects. J Cardiovasc Pharmacol. 1996; 27:80-5.53, Semigran MJ, Cockrill BA, Kacmarek R, Thompson BT, Zapol WM, Dec GW, Fifer MA. Hemodynamic effects of inhaled nitric oxide in heart failure. J Am Coll Cardiol. 1994; 24:982-8.
  53. Loh E, Stamler JS, Hare JM, Loscalzo J, Colucci WS. Cardiovascular effects of inhaled nitric oxide in patients with left ventricular dysfunction. Circulation. 1994; 90:2780-5.
  54. Evora PRB, Viaro F, Oshiro MS, Souza DG. A utilizaçäo do óxido nítrico inalado em cirurgia cardíaca: atualizaçäo e análise crítica. Rev. Bras. Cir. Cardiovasc;17:221-229, 2002.
  55. Dembinski R, Henzler D, Rossaint R. Modulating the pulmonary circulation: an update. Minerva Anestesiol. 2004; 70:239-43.
  56. Timoteo AT, Abecassis M, Baptista P, Rebocho MJ, Queiroz e Melo J.Nitric oxide in the management of pulmonary hypertension in the context of cardiac surgery in the adult. Rev Port Cardiol. 2003; 22:1503-11.
  57. Dietrich CC, Tobias JD.Intraoperative administration of nitric oxide. J Intensive Care Med. 2003; 18:146-9.
  58. Fioretto JR. Inhaled nitric oxide in pediatrics. J Pediatr (Rio J). 2003; 79 Suppl 2:S177-86.
  59. Mebazaa A, Karpati P, Renaud E, Algotsson L.Acute right ventricular failure--from pathophysiology to new treatments. Intensive Care Med. 2004; 30:185-96.
  60. Wang T, El Kebir D, Blaise G.Inhaled nitric oxide in 2003: a review of its mechanisms of action. Can J Anaesth. 2003; 50:839-46.
  61. Sokol J, Jacobs SE, Bohn D.Inhaled nitric oxide for acute hypoxic respiratory failure in children and adults: a meta-analysis. Anesth Analg. 2003; 97:989-98.
  62. Kaisers U, Busch T, Deja M, Donaubauer B, Falke KJ.Selective pulmonary vasodilation in acute respiratory distress syndrome. Crit Care Med. 2003; 31(Suppl):S337-42.
  63. Sokol J, Jacobs SE, Bohn D.Inhaled nitric oxide for acute hypoxemic respiratory failure in children and adults. Cochrane Database Syst Rev. 2003;CD002787.
  64. Robin E, Haddad E, Vallet B. Inhaled nitric oxide in the peroperative period and recovery. Ann Fr Anesth Reanim. 2002; 21:581-90.
  65. Gianetti J, Bevilacqua S, De Caterina R.Inhaled nitric oxide: more than a selective pulmonary vasodilator. Eur J Clin Invest. 2002; 32:628-35.
  66. Estanove S, Girard C, Bastien O, Piriou V, Lehot JJ.Inhaled nitric oxide: therapeutic applications in cardiac surgery. Bull Acad Natl Med. 2000;184:1715-26.
  67. Weinberger B, Laskin DL, Heck DE, Laskin JD. The toxicology of inhaled nitric oxide. Toxicol Sci. 2001; 59:5-16.
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