Intensive Care Medicine

, Volume 22, Issue 10, pp 1093–1095

The use of phosphodiesterase inhibitor (dipyridamole) to wean from inhaled nitric oxide

Authors

  • S. Al-Alaiyan
    • Neonatology Section, Department of Pediatrics (MBC 58)King Faisal Specialist Hospital and Research Centre
  • A. Al-Omran
    • Neonatology Section, Department of Pediatrics (MBC 58)King Faisal Specialist Hospital and Research Centre
  • D. Dyer
    • Neonatology Section, Department of Pediatrics (MBC 58)King Faisal Specialist Hospital and Research Centre
Brief Report

DOI: 10.1007/BF01699234

Cite this article as:
Al-Alaiyan, S., Al-Omran, A. & Dyer, D. Intensive Care Med (1996) 22: 1093. doi:10.1007/BF01699234

Abstract

A full-term, male neonate developed persistent pulmonary hypertension, and responded to high-frequency oscillatory ventilation and inhaled nitric oxide (INO). Discontinuation of INO was attempted three times and was followed by severe desaturations due to right-to-left shunt through the patent ductus arteriosus and patent foramen ovale. As a result of this rebound pulmonary hypertension, the neonate was maintained on INO therapy for 6 days. Successful discontinuation was achieved by using the phosphodiesterase inhibitor, dipyridamole. We speculate that during exogenous INO therapy, endogenous nitric oxide was inhibited, thus cyclic guanosine 3′,5′-monophophate, the smooth muscle relaxant, was rapidly hydrolyzed. By inhibiting phosphodiesterase, smooth muscle relaxation occurred, and consequently weaning from INO was achieved.

Key words

NeonatesPhosphodi-esterase inhibitorNitric oxidePulmonary hypertension

Copyright information

© Springer-Verlag 1996