Exhaled and nasal nitric oxide as a marker of pneumonia in ventilated patients

American Journal of Respiratory and Critical Care Medicine
C AdrieM R Pinsky

Abstract

Because inflammation stimulates the expression of inducible nitric oxide (NO) synthase (iNOS) with an associated increased local NO production, we hypothesized that patients with pneumonia would have increased excretion of NO into their airways. To test this hypothesis, NO was measured in the exhaled air and from the nasal cavities of 49 consecutively intubated and mechanically ventilated patients in our ICU. After excluding NO gas contamination in the inspiratory circuit, nasal NO and end-expiratory and mean exhaled tracheal NO levels and plasma nitrate concentrations were measured using a fast response chemiluminescence analyzer. Twenty-one patients (43%) presented with infectious pneumonia. End- expiratory exhaled NO concentrations were significantly higher in patients with pneumonia as compared with patients without pneumonia (5.9 +/- 1 ppb versus 3.2 +/- 0.5 ppb, p < 0.01). Similarly, mean nasal NO was higher in patients with pneumonia (1039 +/- 138 ppb versus 367 +/- 58 ppb, p = 0.003). Plasma nitrate levels did not differ between patient groups. Threshold values of tracheal or nasal NO were defined and subsequently validated in 60 other patients. Positive and negative values of a maximal tracheal level > 5 ppb for pneumo...Continue Reading

References

Dec 16, 1991·Biochemical and Biophysical Research Communications·L E GustafssonS Moncada
Sep 1, 1988·The American Review of Respiratory Disease·J F MurrayM R Flick
Dec 30, 1993·The New England Journal of Medicine·S Moncada, A Higgs
Mar 1, 1994·American Journal of Respiratory and Critical Care Medicine·G R BernardR Spragg
Feb 1, 1995·The European Respiratory Journal·S A KharitonovP J Barnes
Aug 1, 1995·American Journal of Respiratory and Critical Care Medicine·S A KharitonovP J Barnes
Jan 1, 1995·Journal of Applied Physiology·G CremonaE A Bower
Jan 15, 1994·Lancet·S A KharitonovP J Barnes
May 14, 1994·Lancet·C MünchA T Dinh-Xuan
May 1, 1994·American Journal of Respiratory and Critical Care Medicine·W M ZapolC H Bosken
Jun 1, 1994·Circulation·M HusainW M Zapol
Nov 1, 1993·Proceedings of the National Academy of Sciences of the United States of America·D A WinkJ B Mitchell
Feb 1, 1993·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·S Archer
Oct 1, 1996·Chest·W C DillonS L Archer
Dec 1, 1996·The European Respiratory Journal·J DötschP G Kühl
Dec 1, 1996·The European Respiratory Journal·J O LundbergK Alving
Oct 1, 1996·Archives of Disease in Childhood·J O LundbergK Alving
Mar 28, 1998·American Journal of Respiratory and Critical Care Medicine·W MaziakP J Barnes
Oct 14, 1998·American Journal of Respiratory and Critical Care Medicine·S L ArcherA T Dinh-Xuan
Mar 2, 1999·American Journal of Respiratory and Critical Care Medicine·S E CraterT A Platts-Mills
Mar 2, 1999·American Journal of Respiratory and Critical Care Medicine·C M SalomeA J Woolcock
Mar 2, 1999·American Journal of Respiratory and Critical Care Medicine·P E SilkoffK R Chapman
Jun 27, 2000·Allergologia et immunopathologia·M Giner Muñoz
Oct 13, 2000·American Journal of Respiratory and Critical Care Medicine·W SteudelW M Zapol

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Citations

Jan 31, 2004·Toxicology·Myung S ParkMichael A Dubick
Jun 4, 2010·The Journal of Laryngology and Otology·N CharakliasC A Kendall
Apr 17, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Laura L HammittUNKNOWN Pneumonia Methods Working Group
Aug 13, 2011·Respiration; International Review of Thoracic Diseases·Teresa GarrigaVictòria Cardona
Mar 5, 2002·American Journal of Respiratory and Critical Care Medicine·Martin J Tobin
Aug 21, 2003·American Journal of Respiratory and Critical Care Medicine·Daniel C TörnbergEddie Weitzberg
Feb 24, 2015·Nutrients·Karolina A P WijnandsMartijn Poeze
Feb 13, 2010·Nitric Oxide : Biology and Chemistry·Kenny K K Chung, Karen K David
Nov 14, 2008·Respiratory Medicine·Wilhelm ZetterquistKjell Alving
Jan 20, 2007·Respiratory Medicine·Susan C FoleyPaul McLoughlin
Oct 2, 2003·Pediatric Pulmonology·Steven L OlsenWilliam E Truog
Dec 18, 2003·Clinical and Experimental Immunology·A SoopA Sollevi
Jan 3, 2018·Journal of Breath Research·Pouline M van OortLieuwe D Bos
Sep 6, 2008·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Ian D Pavord, Dominic Shaw
Sep 20, 2012·Journal of Breath Research·Nhât-Nam Le-DongAnh Tuan Dinh-Xuan
Jul 1, 2010·Journal of Cellular Biochemistry·Ting CaoTatsuya Yamagata
Jul 29, 2011·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Mario BarretoMaria Pia Villa

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