title: The role of inhaled nitric oxide beyond ARDS.
abstract: Patients with traumatic brain injury complicated by acute respiratory distress syndrome (ARDS) are not uncommon in intensive care unit (ICU). The ventilatory management of patients combined with both of these catastrophic conditions is not straightforward. Evidence-based permissive hypercapnia strategy for ARDS could be fatal in patients with intracranial hypertension. Adjunctive use of inhaled nitric oxide (INO) is well-defined as a rescue therapy in severe ARDS, but its specific role in intracranial hypertension is somewhat uncertain. We report a case, which following traumatic brain injury developed both intracranial hypertension and ARDS. INO was given for ARDS, but coincidentally it also improved the raised intracranial pressure (ICP) and patient's neurological outcome. The case report will be followed by literature review on the role of INO in raised ICP.
authors.affiliation: Department of Critical Care, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Muhammad Faisal
authors.initials: MF
authors.lastname: Khan
authors.affiliation: Department of Critical Care, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Mohammad Feroz
authors.initials: MF
authors.lastname: Azfar
authors.affiliation: Department of Critical Care, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Syed Moazzum
authors.initials: SM
authors.lastname: Khurshid
keywords: Acute respiratory distress syndrome; permissive hypercapnia and INO; raised intracranial pressure; traumatic brain injury