Inhaled nitric oxide prior to transcatheter embolization of pulmonary AVM in a child with hemorrhagic telangiectasia

Abstract A girl weighing 26 kg came with a one-day history of progressive hypoxia. Physical examination was significant for clubbing, cyanosis, and tachypnea. Inhaled nitric oxide (NO) was administered at 20 ppm to selectively dilate pulmonary vessels as a temporizing treatment for refractory hypoxemia. A chest CT demonstrated a left lower lobe AVM. On the third day of admission, a pulmonary angiogram and embolization was performed by interventional radiology. At the end of the procedure, PaO 2 /FiO 2 increased to 330 from 40, and the angiographic run demonstrated a 70% reduction in the size of the AVM.