One-Year Continuous Inhaled Nitric Oxide for Primary Pulmonary Hypertension

We describe a case of long-term administration of nitric oxide (NO) in a32-year-old man who was admitted with exertional dyspnea and anasarca. A diagnosis of primary pulmonary hypertension was made. An acutevasodilator trial with inhaled NO showed a 5% reduction of the meanpulmonary artery pressure. Long-term NO inhalation therapy wasinitiated. Twenty days later, the dyspnea improved, the anasarcaresolved, and the Pao2 level increased. After12 months of NO therapy, the patient remained stable and no signs of toxicity or tachyphylaxis were observed. To our knowledge, this is thefirst report of 1 year of continuously inhaled NO in an adult patientwith primary pulmonary hypertension. These findings suggest thatprolonged NO therapy might be an effective alternative, at a lowercost, to the continuous IV infusion of epoprostenol.