title: Successful treatment of acute respiratory distress syndrome after hysterectomy for life-threatening atonic bleeding by inhaled nitric oxide.
abstract: We report a case of a 33-year-old female who developed severe acute respiratory distress syndrome (ARDS) after emergency hysterectomy for life-threatening atonic bleeding. A marked decline in pulmonary oxygenation was observed during the surgery, which led to a diagnosis of ARDS. Following admission to the intensive care unit, hypoxia became critical, with a PaO(2)/F(I)O(2) value of 52 even after recruitment maneuvers. Inhaled nitric oxide (NO 10 ppm) was administered to the patient as a rescue treatment, resulting in a gradual but dramatic improvement in pulmonary oxygenation. Although several randomized trials have failed to confirm the beneficial effects of NO on morbidity in patients with ARDS, NO administration is worth consideration as treatment prior to invasive treatments, such as extracorporeal membrane oxygenation, for patients with acute lung injury/ARDS.
authors.affiliation: Department of Anesthesiology, Aomori City Hospital, 1-14-20 Katsuta, Aomori, 030-0821, Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Fujita
authors.forename: Eiji
authors.initials: E
authors.lastname: Hashiba
authors.forename: Noriaki
authors.initials: N
authors.lastname: Otomo
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Muraoka
authors.forename: Futoshi
authors.initials: F
authors.lastname: Kimura
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Hirota
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000188:drug therapy; D007044:Hysterectomy / Q000009:adverse effects*; D009569:Nitric Oxide / Q000008:administration & dosage*; D006473:Postpartum Hemorrhage / Q000601:surgery*; D011247:Pregnancy; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000209:etiology
chemical_list: D009569:Nitric Oxide