Intensive Care Medicine

, Volume 22, Issue 10, pp 1093–1095

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

  • S. Al-Alaiyan
  • A. Al-Omran
  • D. Dyer
Brief Report


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

Neonates Phosphodi-esterase inhibitor Nitric oxide Pulmonary hypertension 


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Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • S. Al-Alaiyan
    • 1
  • A. Al-Omran
    • 1
  • D. Dyer
    • 1
  1. 1.Neonatology Section, Department of Pediatrics (MBC 58)King Faisal Specialist Hospital and Research CentreRiyadhKingdom of Saudi Arabia

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