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Hemoglobin can also incorporate stable metabolites of NO into the red blood cell (RBCs) environment.4 In pulmonary circulation, oxygenation of Hb facilitates NO uptake to form S-nitrosohemoglobin (SNO-Hb) while, in the peripheral circulation, deoxygenation facilitates the transfer of S-nitrosothiols (SNOs) out of RBCs.5 Since SNOs promote vasodilation, the release of NO from Hb to a hypoxic environment result in increased blood flow to hypoxic tissues and would explain the physiological significance of SNO-Hb improving tissue oxygenation (Fig