The effect of inhaled nitric oxide on shunt fraction in mechanically ventilated patients with COVID‑19 pneumonia

Studies in patients with severe acute respiratory distress syndrome (ARDS) with refractory hypoxaemia suggest that inhaled nitric oxide (iNO) can be added to ventilatory strategies as a potential bridge to clinical improvement. However, the potential role of iNO as a management strategy in severe CO...

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Veröffentlicht in:African journal of thoracic and critical care medicine 2023-08, Vol.29 (2), p.64-66
Hauptverfasser: Van Zyl, A G P, Allwood, B W, Koegelenberg, C F N, Lalla, U, Retief, F
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Sprache:eng
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Zusammenfassung:Studies in patients with severe acute respiratory distress syndrome (ARDS) with refractory hypoxaemia suggest that inhaled nitric oxide (iNO) can be added to ventilatory strategies as a potential bridge to clinical improvement. However, the potential role of iNO as a management strategy in severe COVID-19 pneumonia remains unclear. The authors describe their clinical findings of using iNO for severe COVID-19 pneumonia in 10 patients with refractory hypoxaemia in a tertiary respiratory intensive care unit. The results showed an improvement in shunt fraction, P/F ratio, PaO2 and arterial oxygen saturation but the improvements did not translate into a mortality benefit. This report adds to the current body of literature indicating that the correct indications, timing, dose and duration of iNO therapy and how to harness its pleiotropic effects still remain to be elucidated.
ISSN:2617-0191
2617-0205
DOI:10.7196/AJTCCM.2023.v29i2.279