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  • Poster presentation
  • Open Access

Inhaled nitric oxide improves pulmonary functions following massive pulmonary embolism

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  • 1,
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  • 2,
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Critical Care200610 (Suppl 1) :P59

  • Published:


  • Nitric Oxide
  • Pulmonary Embolism
  • Pulmonary Hypertension
  • Acute Respiratory Distress Syndrome
  • Pulmonary Vascular Resistance


Acute pulmonary embolism increases pulmonary resistance and may lead to acute right ventricular failure and cardio circulatory collapse, possibly resulting in substantial morbidity and mortality. Inhaled nitric oxide (NO) dilates pulmonary blood vessels and has been used to reduce pulmonary vascular resistance in patients with chronic thromboembolic pulmonary hypertension and acute respiratory distress syndrome. This case series describes our experience with inhaled NO administered to four patients suffering from acute massive pulmonary embolism following abdominal surgery.


The four described patients were recovering from small bowel resection, pancreatoduodenectomy, hemipelvectomy or recent gastrointestinal bleeding and presented with severe respiratory and hemodynamic deterioration due to pulmonary embolism. Each received inhaled NO (20–25 ppm) via the inspiratory side of the breathing circuit of the ventilator. Pulmonary and systemic blood pressures, heart rate and gas exchange levels improved in all the patients within minutes after the initiation of NO administration.


Inhaled NO may be useful in treating acute massive pulmonary embolism. This potential application warrants further investigation.

Authors’ Affiliations

Surgical Intensive Care, Tel Aviv University, Tel Aviv, Israel
Department of Surgery 'B', Tel Aviv University, Tel Aviv, Israel
Department of Emergency Medicine and Tel Aviv University, Tel Aviv, Israel
Post-Anesthesia Care Units, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel


© BioMed Central Ltd 2006