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Death of a Young Woman Suffering From Primary Pulmonary Hypertension During Inhaled Nitric Oxide Therapy

Juhani Partanen, MD; Marfefeu S. Nieminen, MD
Arch Intern Med. 1995;155(8):875-876. doi:10.1001/archinte.1995.00430080125018.
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Primary pulmonary hypertension is an often fatal disease of mostly young women. Inhaled nitric oxide decreases high pulmonary vascular resistance due to various causes and decreases pulmonary blood pressure.1-4 Nitric oxide has been used as a form

of treatment for primary pulmonary hypertension4 We had an unfortunate experience with this form of treatment.

Report of a Case.  A 22-year-old woman had suffered from primary pulmonary hypertension for the past 3 years. When last seen, she had dyspnea at rest, but had refused transplantation. It was decided to use nitric oxide as a form of treatment.Pulmonary and radial artery catheters were inserted. Fifteen hours later, inhaled nitric oxide therapy (5 parts per million [ppm]) was started. The inhaled nitrogen dioxide concentration remained at 0.1 to 0.5 ppm. The hemodynamic parameters taken before the administration of nitric oxide and at 6 and 9 hours after administration are given in the Table.


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