Advertisement

Change of Nitric Oxide Concentration in Exhaled Gas After Lung Resection

  • Hirohisa Horinouchi
  • Mitsutomo Kohno
  • Masatoshi Gika
  • Atsushi Tajima
  • Katsuyuki Kuwabara
  • Akira Yoshizu
  • Masao Naruke
  • Yotaro Izumi
  • Masafumi Kawamura
  • Koji Kikuchi
  • Koichi Kobayashi
Conference paper
Part of the Keio University Symposia for Life Science and Medicine book series (KEIO, volume 1)

Summary

Nitric oxide (NO) has been shown to have a diversity of biological functions. In patients who undergo lung resection such as lobectomy and pneumonectomy, the vascular bed and its ventilation area are reduced. Few patients, however, develop pulmonary hypertension. Endogenous NO may play a role in stabilizing pulmonary circulation after major lung resection. To evaluate endogenous NO production, NO in exhaled gas was analyzed. From August to December 1996, eight patients with a mean age of 62 years who underwent lung resection (seven lobectomies and one pneumonectomy) were examined. NO concentration in their exhaled gas and minute ventilation volume was measured once in the preoperative period, on postoperative days 1 and 3, and once 1 week after surgery. Patients breathed pure oxygen, which contained no NO, through a mouthpiece; exhaled gas was introduced directly to the NO analyzer. NO concentration was analyzed continuously by the chemiluminescence method and recorded. Mean concentration of exhaled NO and total NO in exhaled gas in 1 min were calculated. For minute ventilation volume, there was a significant increase between preoperative examination and postoperative day 1. A significant increase in NO concentration in exhaled gas was observed at 1 day after lung resection. To standardize the change of NO concentration and total exhalation volume, the ratio compared to preoperative data was evaluated. The ratio of NO concentration compared to preoperative data changed 191% ± 109%, 296% ± 152%, and 93.7% ± 65.0% at postoperative days 1 and 3 and at 1 week postoperatively, respectively. The ratio of NO production changed 230% ± 119%, 363% ± 205%, and 119% ± 86.2% at postoperative days 1 and 3 and 1 week, respectively. There was a significant difference in NO concentration between preoperative data and postoperative day 3, and significant differences in total NO volume exhaled in 1 min between preoperative data and postoperative days 1 and 3. In conclusion, we showed that after lung resection, NO in the exhaled gas increases in concentration and total volume in unit time, which might be an important factor that prevents alteration of pulmonary circulation. Further careful study is necessary to clarify the mechanism and role of increased NO in exhaled gas after lung resection.

Keywords

Nitric Oxide Nitric Oxide Pulmonary Arterial Pressure Pulmonary Circulation Lung Resection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Ignarro LJ, Burga GM, Woods KS, et al. (1987) Endothelium-derived relaxing factor produced and released from artery and vein is nitric oxide. Proc Natl Acad Sci USA 84: 9265–9269PubMedCrossRefGoogle Scholar
  2. 2.
    Massaro AF, Gaston B, Kita D, et al. (1955) Expired nitric oxide levels during treatment of acute asthma. Am J Respir Crit Care Med 152: 800–803Google Scholar
  3. 3.
    Roberts JD Jr, Polaner DM, Lang P, Zapol WM (1992) Inhaled nitric oxide in persistent pulmonary hypertention of the newborn. Lancet 340: 818–819PubMedCrossRefGoogle Scholar
  4. 4.
    Malinski T, Bailey F, Zang ZG, Chopp M (1993) Nitric oxide measures by porphyrinic microsensor in rat brain after transient middle cerebral artery occlusion. J Cereb Blood Flow Metab 13: 355–358PubMedCrossRefGoogle Scholar
  5. 5.
    Barnes PJ, Belvisi MG (1993) Nitric oxide and lung disease. Thorax 48: 1034–1043PubMedCrossRefGoogle Scholar
  6. 6.
    Kharitonov SA, Chung KF, Evans D, et al. (1996) Increased exhaled nitric oxide in asthma is mainly derived from the lower respiratory tract. Am J Respir Crit Care Med 153: 1773–1780PubMedGoogle Scholar
  7. 7.
    Okada M, Ota T, Okada N (1994) Right ventricular dysfunction after major pulmonary resection. J Thorac Cardiovasc Surg 108: 503–511PubMedGoogle Scholar
  8. 8.
    Williams EA, Evans TW, Goldstraw P (1996) Acute lung injury following lung resection: is one-lung anaesthesia to blame? Thorax 51: 114–116PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1998

Authors and Affiliations

  • Hirohisa Horinouchi
    • 1
  • Mitsutomo Kohno
    • 1
  • Masatoshi Gika
    • 1
  • Atsushi Tajima
    • 1
  • Katsuyuki Kuwabara
    • 1
  • Akira Yoshizu
    • 1
  • Masao Naruke
    • 1
  • Yotaro Izumi
    • 1
  • Masafumi Kawamura
    • 1
  • Koji Kikuchi
    • 1
  • Koichi Kobayashi
    • 1
  1. 1.Department of Surgery, School of MedicineKeio UniversityShinjuku-ku, Tokyo 160Japan

Personalised recommendations