intrinsic Nitric Oxide and vital organs

Q;  iNO (intrinsic Nitric Oxide) increases the risk of which organ dysfunction?

A) Heart
B) Lung
C) Kidney
D) Spleen
E) Liver


Answer: C 

 iNO may increase the risk of kidney dysfunction, particularly in patients who are in ICU for a prolong period of time and requires it prolong use as in ARDS.

iNO actually is beneficial to heart as a right heart afterload reducer (choice A) and improves hypoxemia (choice B), though it failed to show any improvement in mortality so far.

iNO has no significant effect on liver or spleen enzymes (choice D and E). In fact, recently it's use has been advocated during liver transplantation. 3

#nephrology
#transplantation
#cardiology
#pulmonary
#pharmacology


References:

1. Ruan SY, Huang TM, Wu HY, et al. Inhaled nitric oxide therapy and risk of renal dysfunction: a systematic review and meta-analysis of randomized trials. Crit Care 2015; 19:137. 

2. Gebistorf F, Karam O, Wetterslev J, Afshari A. Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) in children and adults. Cochrane Database Syst Rev 2016; :CD002787.

3. Fukazawa K, Lang JD. Role of nitric oxide in liver transplantation: Should it be routinely used? World Journal of Hepatology. 2016;8(34):1489-1496.