Skip to main content
Article thumbnail
Location of Repository

Successful use of inhaled nitric oxide to decrease intracranial pressure in a patient with severe traumatic brain injury complicated by acute respiratory distress syndrome: a role for an anti-inflammatory mechanism?

By Thomas J Papadimos, Azedine Medhkour and Sooraj Yermal


Use of inhaled nitric oxide in humans with traumatic brain injury and acute respiratory distress syndrome has twice previously been reported to be beneficial. Here we report a third case. We propose that INO may decrease the inflammatory response in patients with increased intracranial pressure caused by traumatic brain injury accompanied by acute respiratory distress syndrome thereby contributing to improved outcomes

Topics: Case Report
Publisher: BioMed Central
OAI identifier:
Provided by: PubMed Central

Suggested articles


  1. (2007). A: Glucocorticoid receptor expression in the cortex of the neonatal rat brain with and without focal ischemia. Neonatology
  2. (1961). Adrenocortical respose to stress in rats with lesions in hippocampus and amygdala. Proc Soc Exp Biol Med
  3. (2001). Adrenocorticosteroid receptor blockade and excitotoxic challenge regulated adrenocorticosteroid receptor mRNA levels in the hippocampus.
  4. (2001). AM: The influence of inhaled nitric oxide on cerebral blood flow and metabolism in a child with traumatic brain injury. Anesth Analg
  5. (2005). Angus DC: Acute Lung Injury – affecting many lives.
  6. (1984). BS: Glucocorticoid-sensitive hippocampal neurons are involved in terminating the adrenocortical response. Proc Natl Acad Sci USA
  7. (1986). BS: The neuroendocrinology of stress and aging: the glucocorticoid cascade hypothesis. Endocr Rev
  8. (2001). Cerebral blood flow velocity acutely decreases in newborns who respond to inhaled nitric oxide.
  9. (2007). Cinel I: Inhaled nitric oxide therapy for sepsis: more that just lung. Crit Care Med
  10. (2005). CJ: Non-neurologic organ dysfunction in severe traumatic brain injury. Crit Care Med
  11. (2006). CJ: Ventilator-associated pneumonia in severe traumatic brain injury. Neurocrit Care
  12. (2005). delgli Uberti EC: Hypopituitarism after traumatic brain injury.
  13. (2000). den: Novel insights into the neuroendocrinology of critical illness.
  14. (1992). Detection of nitric oxide production in lipopolysaccharide-treated rats by ESR using carbon monoxide hemoglobin. Biochem Biophys Res Commun
  15. DW: Traumatic Brain Injury. In Textbook of Critical Care Edited by: Fink
  16. (1999). Effet du monoxyde d'azote inhale chez une patiente atteinte d'hypertension intracranienne. Ann Fr Anesth Reanim
  17. (2005). Evans TW: Inhaled nitric oxide therapy in adult.
  18. (1963). Evidence of inhibitive role of hippocampus in neural regulation of ACTH release. Proc Soc Exp Biol Med
  19. (1961). G: The effect of hippocampal lesion on pituitary-adrenal function. Acta Physiol Acad Sci Hung
  20. (2006). Hedenstierna G: Nitric oxide up-regulates the glucocorticoid receptor and blunts the inflammatory reaction in porcine endotoxin sepsis. Crit Care Med
  21. (2005). Hemoglobin conformation couples erythrocyte S-nitrosothio content to O2 gradients. Proc Nat Acad Sci USA
  22. (2005). Hemoglobin-mediated, hypoxiainduced vasodilation via nitric oxide: mechanism(s) and physiologic versus pathological relevance.
  23. (2002). Inflammatory response in acute brain injury: a double-edged sword. Curr Opin Crit Care
  24. (1994). JP: Acute effects of inhaled nitric oxide in children with severe hypoxemic respiratory failure.
  25. (2007). Kaapa P: Inhaled nitric oxide treatment inhibits neuronal injury after meconium aspiration in piglets. Early Hum Dev
  26. (2005). Kaapa PO: Meconium aspiration induces neuronal injury in piglets. Acta Paediatr
  27. (1997). Kaasik AE: Changes of sympatho-adrenal and hypothalamo-pituitary-adrenocortical system in patients with head injury. Acta Neurol Scand
  28. (1994). Kunkel SL: Acute Lung Injury: the role of cytokines in the elicitation of neutrophils.
  29. (2005). LD: Incidence and outcomes of acute lung injury.
  30. (1996). Lopes AD: Global Health Statistics Geneva: World Health Organization;
  31. (2005). Massive brain injury enhances lung damage in an isolated lung model of ventilator-induced injury. Crit Care Med
  32. (2000). MB: S-nitrosothiol formation in blood of lipopolysaccharide-treated rats.
  33. (2002). Mifepristone protects CA1 hippocampal neurons following traumatic brain injury in rat. Neuroscience
  34. (1984). Orr SE: Differential plasma corticosterone responses to hippocampal stimulation. Exp Brain Res
  35. (2007). Perez-Barcena I: Relationship between plasma adrenocorticotropin hormone and intensive care unit survival in early traumatic brain injury.
  36. (1966). PH: Corticosteroid responses to limbic stimulation in man: localization of stimulation sites. Science
  37. (2003). Pittet JF: The development of acute lung injury is associated with worse neurologic outcome in patients with severe traumatic brain injury.
  38. (2003). PK: Comparative analysis of mRNA levels in the frontal cortex and the hippocampus in the basal state and in response to experimental brain injury. Neuropathol Appl Neurobiol
  39. (2005). Plas AA van der: Hyperventilation in head injury: a review. Chest
  40. (2004). Sakinci U: Ultrastructural changes in pneumatocyte type II cells following traumatic brain injury in rats.
  41. (1991). Sapolsky RM: The role of the hippocampus in feedback regulation of the hypothalamic-pituitary-adrenocortical axis. Endocr Rev
  42. (1993). SD: Cerebral perfusion in head injury.
  43. (2006). Seroogy K: Hypothalanic-pituitary-adrenal axis, glucocorticoids, and neurologic disease. Neurol Clin
  44. (2001). Sharples PM: The hypothalamo-pituitary-adrenal axis response to experimental traumatic brain injury.
  45. (2003). Singel DJ: Routes to S-nitroso-hemoglobin formation with heme redox and preferential reactivity in the B subunits. Proc Nat Acad Sci USA
  46. (1995). SJ: Contribution of the ventral subiculum to inhibitory regulation of the hypothalamic-pituitary-adrenocortical axis.
  47. (1989). SJ: Evidence for hippocampal regulation of neuroendocrine neurons of the hypothalamic-pituitary-adrenocortical axis.
  48. (1992). SJ: Selective forebrain fiber tract lesions implicate ventral hippocampal structures in tonic regulation of paraventricular nucleus CRH and AVP mRNA expression. Brain Res
  49. (2003). Slutsdky AS: One year outcomes in survivors of the acute respiratory syndrome.
  50. (2006). The biological chemistry of nitric oxide as it pertains to the extrapulmonary effects of inhaled nitric oxide. Proc Am Thorac Soc
  51. (2006). The incidence and economic burden of injuries in the United States
  52. (1999). Traumatic brain injury in the United States: a public health perspective. J Head Trauma Rehabil
  53. (2002). Traumatic brain injury regulates adrenocorticosteroid receptor mRNA levels in rat hippocampus. Brain Res

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.