Addition of Nitric Oxide to Oxygen Improves Cardiopulmonary Function in Patients With Severe COPD

To assess the effect of nitric oxide inhalation on pulmonary hemodynamics and oxygenation in patients with COPD receiving long-term oxygen therapy (LTOT). Prospective study. ICU of a university medical center. A total of 18 (6 female, 12 male) patients with COPD, spontaneously breathing with LTOT. Oxygenation and hemodynamic variables were measured and calculated at an inspired oxygen fraction (FIo2) adjusted to mimic LTOT conditions (control), and then 1 h after each sequential addition of 5, 10, and 20 ppm nitric oxide to the gas mixture. A newly developed device (Pulmonox) provided both the delivery and continuous analysis of nitric oxide and oxidative nitric oxide products. There was a significant improvement in oxygenation at 5 ppm nitric oxide (PaO2/FIo2 ratio improved from 244±37 to 303±59, p