[Experiences with inhalative nitric oxide in internal medicine intensive care patients with adult respiratory distress syndrome].
Inhalative nitric oxide (NO) has recently been included in the therapeutic armament for the treatment of ARDS. We evaluated the effect of inhalative NO on hemodynamic and oxygen transport parameters in 30 internal intensive care patients suffering from ARDS. All patients received a pulmonary artery catheter. Hemodynamics were assessed prior to NO therapy and after 1, 6, 12, and 24 h. 80% (n = 24) of the patients were classified as therapy responders. The median NO dose was 15 ppm (range 5 to 40 ppm). The PaO2/FiO2--ratio increased significantly after initiation of NO (p = 0.0002) while the pulmonary shunt fraction (Qs/Qt) decreased significantly (p = 0.0019). All other measured or calculated parameters including arterial and pulmonary arterial blood pressure remained unchanged. No negative effects of the therapy could be observed. Inhalative NO improves oxygenation in most intensive care patients with ARDS and thus offers the possibility to reduce invasiveness of mechanical ventilation.
Universitätsklinik für Innere Medizin I, Wien. thomas.staudinger@akh-wien.ac.at
T
T
Staudinger
M
M
Müllner
A
A
Wagner
G J
GJ
Locker
K
K
Laczika
S
S
Knapp
H
H
Burgmann
B
B
Stoiser
J
J
Kofler
M
M
Frass
D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D003422:Critical Care; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000008:administration & dosage*; D011652:Pulmonary Circulation / Q000187:drug effects / Q000502:physiology; D011659:Pulmonary Gas Exchange / Q000187:drug effects / Q000502:physiology; D012128:Respiratory Distress Syndrome / Q000503:physiopathology / Q000628:therapy*
D009569:Nitric Oxide