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Clinical Concepts and Commentary  |   February 2001
Is There a Place for Inhaled Nitric Oxide in the Therapy of Massive Pulmonary Embolism?
Author Affiliations & Notes
  • George F. Rich, M.D., Ph.D.
    *
  • * University of Virginia Health System, Charlottesville, Virginia. gfr2f@virginia.edu
Article Information
Clinical Concepts and Commentary
Clinical Concepts and Commentary   |   February 2001
Is There a Place for Inhaled Nitric Oxide in the Therapy of Massive Pulmonary Embolism?
Anesthesiology 2 2001, Vol.94, 354. doi:
Anesthesiology 2 2001, Vol.94, 354. doi:
In Reply:—
We presented a brief overview of the perioperative uses of inhaled nitric oxide (NO). Although we covered the most common indications for inhaled NO, the letter by Tanus-Santos correctly suggests that additional uses have been described, such as the management of pulmonary embolism. There are also case reports of the use of inhaled NO in hepato-pulmonary syndrome and after heparin-protamine reactions. Since the publication of our article, inhaled NO has received Food and Drug Administration approval for term and near-term (older than 34 weeks) neonates with hypoxic respiratory failure associated with pulmonary hypertension. It is important to realize that all other uses of inhaled NO are considered “off-label.” Furthermore, consideration of the use of inhaled NO to treat pulmonary hypertension with or without hypoxemia should include its considerable cost.