title: Inhaled nitric oxide in adult patients with acute respiratory distress syndrome.
abstract: In some patients, acute respiratory distress syndrome (ARDS) leads to life-threatening refractory hypoxemia developing. Physicians may consider hypoxemic rescue therapies in an attempt to improve oxygenation in these patients while on conventional mechanical ventilation support. Use of inhaled nitric oxide (iNO) in ARDS is one of the most widely-studied pharmacological interventions over the past two decades. Its efficacy was examined in several randomized clinical trials and has undergone meta-analyses. Although iNO treatment was associated with improved oxygenation, researchers unfortunately never demonstrated a concomitant decrease in mortality or any improved outcome. Hence the current evidence suggests that iNO should not be routinely used in patients with ARDS however may be considered as adjunct therapy to tentatively improve oxygenation while other therapies are being considered in patients with severely hypoxemic ARDS.This review focuses on the therapeutic use of iNO in adult ARDS patients. We set out some recommendations for its use as rescue therapy against refractory hypoxemia.
authors.affiliation: Anesthesiology and Recovery Department. Albacete University Hospital Complex. Integrated Healthcare Management Office for Albacete. Calle Hermanos Falcó 37, Albacete.. jose_mn@hotmail.com.
authors.forename: José Ángel
authors.initials: JÁ
authors.lastname: Monsalve-Naharro
authors.affiliation: Hospital Pharmacy Department. Albacete University Hospital Complex. Integrated Healthcare Management Office for Albacete. Calle Hermanos Falcó 37, Albacete.. estherdomingochiva@hotmail.com.
authors.forename: Esther
authors.initials: E
authors.lastname: Domingo-Chiva
authors.affiliation: Pulmonology Department. Albacete University Hospital Complex. Integrated Healthcare Management Office for Albacete. Calle Hermanos Falcó 37, Albacete.. jose_mn@hotmail.com.
authors.forename: Sergio
authors.initials: S
authors.lastname: García Castillo
authors.affiliation: Anesthesiology and Recovery Department. Albacete University Hospital Complex. Integrated Healthcare Management Office for Albacete. Calle Hermanos Falcó 37, Albacete.. jose_mn@hotmail.com.
authors.forename: Pablo
authors.initials: P
authors.lastname: Cuesta-Montero
authors.affiliation: Anesthesiology and Recovery Department. Albacete University Hospital Complex. Integrated Healthcare Management Office for Albacete. Calle Hermanos Falcó 37, Albacete.. jose_mn@hotmail.com.
authors.forename: José María
authors.initials: JM
authors.lastname: Jiménez-Vizuete
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D006801:Humans; D009569:Nitric Oxide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012128:Respiratory Distress Syndrome / Q000188:drug therapy*
chemical_list: D009569:Nitric Oxide