| Dose-response characteristics during long-term inhalation of nitric oxide in patients with severe acute respiratory distress syndrome: a prospective, randomized, controlled study. | |
| | |
MedLine Citation:
|
PMID: 12663340 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Inhaled nitric oxide (NO) improves systemic oxygenation (PaO2/FIO2) in adult patients with acute respiratory distress syndrome (ARDS). However, individual response varies, and previous trials demonstrated no outcome benefit. This prospective, randomized study in 40 ARDS patients analyzed dose-response (DR) characteristics during long-term inhaled NO. Patients were randomized for conventional therapy (control) or continuous treatment with 10 parts per million (ppm) inhaled NO until weaning was initiated. We measured DR curves of PaO2/FIO2 versus the inhaled NO dose at regular intervals. Before treatment (Day 0), peak improvement in PaO2/FIO2 was achieved at 10 ppm for both control and NO-treated patients. After 4 days, the DR curve of the NO-treated patients was left shifted with a peak response at 1 ppm. At higher doses (10 and 100 ppm), oxygenation deteriorated, and the response to inhaled NO disappeared in several patients. This effect was not observed in the control group. There was no effect of inhaled NO on duration of mechanical ventilation or stay at the intensive care unit. In conclusion, long-term inhaled NO with constant doses of 10 ppm leads to enhanced sensitivity after several days and does do not allow reduction of ventilation parameters. Hence, previous trials on therapy with inhaled NO in ARDS should be carefully interpreted, as they used constant NO concentrations, which may have become overdoses leading to deterioration of oxygenation after several days. |
| | |
Authors:
|
Herwig Gerlach; Didier Keh; Alexander Semmerow; Thilo Busch; Klaus Lewandowski; Dirk M Pappert; Rolf Rossaint; Konrad J Falke |
Publication Detail:
|
Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: American journal of respiratory and critical care medicine Volume: 167 ISSN: 1073-449X ISO Abbreviation: Am. J. Respir. Crit. Care Med. Publication Date: 2003 Apr |
Date Detail:
|
Created Date: 2003-03-28 Completed Date: 2003-05-30 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: United States |
Other Details:
|
Languages: eng Pagination: 1008-15 Citation Subset: AIM; IM |
Affiliation:
|
Vivantes-Klinikum Neukoelln, Klinik für Anaesthesie, Operative Intensivmedizin und Schmerztherapie, Rudower Strasse 48, D-12313 Berlin, Germany. herwig.gerlach@knk-berlin.de |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acute Disease Administration, Inhalation Adolescent Adult Bronchodilator Agents / administration & dosage*, therapeutic use* Dose-Response Relationship, Drug Extracorporeal Membrane Oxygenation Female Humans Male Middle Aged Nitric Oxide / administration & dosage*, therapeutic use* Predictive Value of Tests Prospective Studies Pulmonary Ventilation / drug effects Respiratory Distress Syndrome, Adult / therapy* Severity of Illness Index Time Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Bronchodilator Agents; 10102-43-9/Nitric Oxide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Airborne endotoxin predicts symptoms in non-mouse-sensitized technicians and research scientists exp...
Next Document: The inducible nitric oxide synthase inhibitor BBS-2 prevents acute lung injury in sheep after burn a...