PMID: 9523806Apr 2, 1998Paper

The response to repeated nitric oxide inhalation is inconsistent in patients with acute respiratory distress syndrome

Anesthesiology
M Treggiari-VenziP M Suter

Abstract

Nitric oxide (NO) is administered frequently in patients with acute respiratory distress syndrome (ARDS) and pulmonary hypertension. The efficacy of this therapy over several days is not well known. The authors first determined the consistency of the response to repeated administration of NO and then the baseline variables that were associated with improvement in patients with severe ARDS. In a prospective trial, 32 mechanically ventilated patients with severe ARDS received 10 parts per million NO by inhalation. In 22 of these patients, its effect was tested repeatedly (up to four times) in several days. Improvement was defined as an increase >10% in the ratio of pressure of oxygen in arterial blood (P(aO2)) to the inspiratory pressure of oxygen (FIO2) from baseline. Patients showing such an improvement were maintained on NO inhalation. Twelve of the 22 patients (54%) showed a clinically significant and reproducible increase in the P(aO2)/FIO2 ratio with NO, from 74 +/- 30 mmHg (mean +/- SD) to 95 +/- 41 mmHg (P < 0.001). In three patients (14%), P(aO2) did not improve, even with multiple exposures. In seven patients (32%), an inconsistent response was seen on different days. Mean pulmonary artery pressure decreased for the ent...Continue Reading

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Citations

Jul 3, 1999·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·R J ByrickG Edelist
Oct 3, 2006·Current Opinion in Anaesthesiology·J Meyer, M Booke
Jan 25, 2003·International Anesthesiology Clinics·Younsuck Koh, William E Hurford
Feb 2, 1999·American Journal of Respiratory and Critical Care Medicine·R GustD P Schuster
May 23, 2003·Anesthesia and Analgesia·Lars G FischerHartmut Bu Combining Diaeresis Rkle

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