Experience with inhaled nitric oxide therapy in patient with neurogenic pulmonary edema: A case report

Park, Eun Sun; Huh, In Young; Kim, Dae Young; Park, Soon Eun; Lee, Ok Kyung

Case Report

Neuroanesthesia

Anesthesia and Pain Medicine 2010;5(3):236-239.
Published online July 31, 2010.

Experience with inhaled nitric oxide therapy in patient with neurogenic pulmonary edema: A case report

Eun Sun Park, In Young Huh, Dae Young Kim, Soon Eun Park, Ok Kyung Lee

Department of Anesthesiology and Pain Medicine, Ulsan University Hospital, Ulsan, Korea. inyoung_huh@uuh.ulsan.kr

Abstract

Neurogenic pulmonary edema is known in patients after head injuries or other cerebral lesions. Typically, this form of pulmonary edema occurs minutes to hours after central nervous system injury and may manifest during the perioperative period. It is always a life-threatening symptom after increased intracranial pressure (ICP), where immediate therapeutic interventions are imperative. Rapid initiation of strategies aimed at ameliorating hypoxia including support of oxygenation and ICP reduction is paramount. We report a case that responded dramatically to inhaled nitric oxide (NO). This therapy, to our experience, seems to provide a way not to reduce pulmonary hypertension, but to improve ventilation-perfusion mismatch for the treatment of refractory hypoxemia in neurogenic pulmonary edema patient.

Key Words: Hypoxemia, Inhaled nitric oxide, Neurogenic pulmonary edema