Effect on dyspnoea and hypoxaemia of inhaled N(G)-nitro-L-arginine methyl ester in hepatopulmonary syndrome

Hepatopulmonary syndrome--a complication of chronic liver disease-is characterised by hypoxaemia, which results from widespread intrapulmonary vascular dilatations. Amplified production of pulmonary nitric oxide is thought to be important in development of this disorder in patients with liver cirrho...

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Bibliographic Details
Published in:The Lancet (British edition) 2003-07, Vol.362 (9377), p.43-44
Main Authors: Brussino, L, Bucca, C, Morello, M, Scappaticci, E, Mauro, M, Rolla, G
Format: Article
Language:English
Subjects:
Administration, Inhalation
Drug therapy
Dyspnea - drug therapy
Dyspnea - etiology
Enzyme Inhibitors - administration & dosage
Hepacivirus
Hepatitis C - complications
Hepatopulmonary Syndrome - complications
Hepatopulmonary Syndrome - drug therapy
Humans
Hypoxia - drug therapy
Hypoxia - etiology
Liver cirrhosis
Liver Cirrhosis - complications
Male
Medical treatment
Middle Aged
NG-Nitroarginine Methyl Ester - administration & dosage
Nitric Oxide Synthase - antagonists & inhibitors
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Summary:Hepatopulmonary syndrome--a complication of chronic liver disease-is characterised by hypoxaemia, which results from widespread intrapulmonary vascular dilatations. Amplified production of pulmonary nitric oxide is thought to be important in development of this disorder in patients with liver cirrhosis. Here, we report a 64-year-old man with hepatopulmonary syndrome associated with hepatitis-C-virus-related cirrhosis. We gave the patient nebulised N(G)-nitro-L-arginine methyl ester (L-NAME), an inhibitor of NO synthesis, which enhanced oxygenation (arterial oxygen pressure increased from 6.98 to 9.45 kPa). After L-NAME, the distance the patient could walk in 6 min rose by 92 m. Administration of L-NAME by aerosol might offer a new approach to treatment of hepatopulmonary syndrome.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(03)13807-X