Main Article Content


Eisenmenger Syndrome is congenital heart disease with pulmonary hypertension and shunting turning from right to left. The resistance of pulmonary vascular more than 7.5 mmHg/L/min. The right ventricle and pulmonary artery always enlarge. Physiological effects of inhaled nitric oxide therapy cause selective pulmonary vasodilation: Hypoxia alveoli causes reversible vasoconstriction, thereby increasing pulmonary wedge pressure. Inhaled nitric oxide can lower it. Moderate cardiac output and systematic arterial pressure are not affected; Selective in pulmonary because it is activated by hemoglobin; Selective vasodilation in the ventilated area, local hypoxia alveoli constricts the surrounding vascular tissue and redistributes blood flow to the ventilated lungs better and higher intraalveolar oxygen pressure. Inhaled nitric oxide enhances this mechanism by increasing blood flow through a well-ventilated lung; Bronchodilators; Pulmonary surfactant, The combination of high concentrations of inspired oxygen and high concentrations of Inhaled nitric oxide reduces the minimum surfactant surface tension.

Article Details

How to Cite
Triastuti, N., Airlangga, M. P., & Anas, M. (2020). Usage of Inhaled Nitric Oxides in Cases of Eisenmenger Syndrome. Indonesian Journal of Medical Sciences and Public Health           &Nbsp; , 1(1), 13-19. Retrieved from


1. Steudel W, Hurford WE, Zapol WM. Inhaled Nitric Oxide Basic Biology and Clinical Applications. Anesthesiol J Am Soc Anesthesiol. 1999;91(4):1090.
2. Anggard E. Nitric Oxide: mediator, murderer, and medicine. Lancet. 1994;343:1199–206.
3. Atz AM, Wessel DL. Inhaled Nitric Oxide in the Neonate with Cardiac Disease. Semin Perinatol. 1997;21(5):441–55.
4. Chen C. Nitric Oxide For Newborns Nitric Oxide Proves Effective In Treating Newborns With Life-Threatening Lung Disorder [Internet]. 1997. Available from: cwchen@ITSA.UCSF.EDU
5. Finer NN, Barrington KJ. Nitric oxide in respiratory failure in the newborn infant. In: Seminars in perinatology. Elsevier; 1997. p. 426–40.
6. Barrington KJ, Finer N, Pennaforte T, Altit G. Nitric oxide for respiratory failure in infants born at or near term. Cochrane Database Syst Rev. 2017;(1).
7. Cheitlin MD, Sokolow M, Melroy MB. Congenital Heart Disease (With Special Reference to Adult Cardiology). In: Clinical Cardiology. 6th Editon. Appleton & Lange; 1993. p. 386–91.
8. Cheitlin MD, Sokolow M, Melroy MB. Heart Diseases in Pregnancy. In: Clinical Cardiology. 6th Editon. Appleton & Lange; 1993. p. 693–703.
9. McAnulty JH, Metcalfe J, Ueland K. Heart Disease In Pregnancy. In: The Heart Arteries and Veins. 8th Editio. McGraw-Hill, Inc; 1994. p. 2041–56.
10. Brennan K, Hatch DM. Eisenmenger’s Syndrome. In: Consults in Obstetric Anesthesiology. Switzerland: Springer Nature; 2018. p. 185–7.
11. Gibbs CP. Anesthetic Management of High-Risk Mother. In: Sciarra Gynecology and Obstetrics. J.B. Lippincott Company; 1988. p. 1–11.
12. Sullivan JM, Ramanathan KB. Heart Disease in Pregnancy. In: Sciarra Gynecology and Obstetrics. J.B. Lippincott Company; 1988. p. 1–16.
13. Lust KM, Boots RJ, Dooris M, Wilson J. Management of labor in Eisenmenger syndrome with inhaled nitric oxide. Am J Obstet Gynecol. 1999;181(2):419–23.
14. Korde Choudhari S, Chaudhary M, Bagde S, Gadbail AR, Joshi V. Nitric oxide and cancer: A review. World J Surg Oncol. 2013;11(1):118.
15. Cheung PY, Salas E, Schulz R, Radomski MW. Nitric Oxide and Platelet Function: Implications for pregnancy. Semin Perinatol. 1997;21(5):409–17.
16. Omer N, Rohilla A, Rohilla S, Kushnoor A. Review article nitric oxide : role in human biology. Int J Pharma Sci Drug Res. 2012;4(2):105–9.
17. Kinsella JP, Abman SH. Inhaled nitric oxide in the premature infant: animal models and clinical experience. In: Seminars in perinatology. Elsevier; 1997. p. 418–25.
18. Anas M, Marlina U. Penggunaan Nitrovasodilator Sebagai Donor Oksida Nitrik Pada Preeklamsia. In: Proceeding Annual Meeting APKKM Ke 6 Surabaya [Internet]. ID; 2018. p. 1–27. Available from:
19. Kim S, Hyun J, Kim H, Kim Y, Kim E, Jang J, et al. Effects of Lead exposure on nitric oxide-associated gene expression in the olfactory bulb of mice. Biol Trace Elem Res. 2011;142(3):683–92.
20. Gillis HC, Gupta S, Skoglund A, Ritter S. Changing Ordering Practice for Inhaled Pulmonary Hypertension Treatment in the Icu. Am Acad Pediatrics; 2018.
21. Satoh T, Xu Q, Wang L, Gladwin MT. Hemolysis-mediated toxicity during cardiopulmonary bypass ameliorated by inhaled nitric oxide gas. Vol. 198, American Journal of Respiratory and Critical Care Medicine. American Thoracic Society; 2018. p. 1244–6.
22. Weale J, Kelleher AA. Adult congenital heart disease. In: Anaesthesia and Intensive Care Medicine. McGraw-Hill, Inc; 2018. p. 285–91.
23. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. CONGENITAL HEART DISEASE. In: Williams Obstetrics. 24th editions. USA: Mc Graw Hill; 2014. p. 973–99.
24. Fishman AP. Pulmonary Hypertension. In: The Heart Arteries and Veins. McGraw-Hill, Inc; 1994. p. 1857–74.
25. Beghetti M, Galiè N. Eisenmenger Syndrome. A Clinical Perspective in a New Therapeutic Era of Pulmonary Arterial Hypertension. J Am Coll Cardiol. 2009;53(9):733–40.
26. Vongpatanasin W, Brickner ME, Hillis LD, Lange RA. Eisenmenger syndrome in adults. Ann Intern Med. 1998;128(9):745–55.
27. D’Alto M, Merola A, Dimopoulos K. Pulmonary hypertension related to congenital heart disease. A comprehensive review. Glob Cardiol Sci Pract. 2005;13:42.
28. Trojnarska O, Plaskota K. Therapeutic methods used in patients with Eisenmenger syndrome. Cardiol J. 2009;16(6):500–6.
29. D’Alto M, Diller G-P. Pulmonary hypertension in adults with congenital heart disease and Eisenmenger syndrome: current advanced management strategies. Heart. 2014;100(17):1322–8.
30. Hjortshøj CS, Jensen AS, Søndergaard L. Advanced Therapy in Eisenmenger Syndrome. Cardiol Rev. 2017;25(3):126–32.
31. Huang J-B, Liang J, Zhou L-Y. Eisenmenger syndrome: not always inoperable. Respir Care. 2012;57(9):1488–95.
32. Fukushima H. Update on medical treatment of patients with Eisenmenger syndrome. Int Heart J. 2005;56(Supplement):s4-7.
33. Zhang Z-N, Jiang X, Zhang R, Li X-L, Wu B-X, Zhao Q-H, et al. Oral sildenafil treatment for Eisenmenger syndrome: a prospective, open-label, multicentre study. Heart. 2011;97(22):1876–81.
34. McCarthy PM, Rosenkranz ER, White RD, Rice TW, Sterba R, Vargo R, et al. Single-Lung transplantation with atrial septal defect repair for Eisenmenger’s syndrome. Ann Thorac Surg. 1991;52(2):300–3.
35. Karelkina E, Irtyuga O, Kokonina Y, Yakubov A, Li O, Mazurok V, et al. The pregnancy outcomes and delivery in women with Eisenmenger’s syndrome. Vol. 7, Pregnancy. 2019. p. 3466.

Most read articles by the same author(s)