Document Detail


A randomized trial of inhaled nitric oxide to prevent ischemia-reperfusion injury after lung transplantation.
MedLine Citation:
PMID:  12770854     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Inhalation of nitric oxide (NO) has been advocated as a method to prevent ischemia-reperfusion injury after lung transplantation. We enrolled 84 patients into a concealed, randomized, placebo-controlled trial to evaluate the effect of inhaled NO (20 ppm NO or nitrogen) initiated 10 minutes after reperfusion on outcomes after lung transplantation. The groups (n = 42) were balanced with respect to age, sex, lung disease, procedure, and total ischemic times. PaO2/FIO2 ratios were similar on admission to the intensive care unit (ICU) (NO 361 +/- 134; control patients 357 +/- 132), and over the duration of the study. There were no differences in hemodynamics between the two groups. Severe reperfusion injury (PaO2/FIO2 < 150) was present at the time of admission to the ICU in 14.6% NO patients versus 9.5% of control patients (p = 0.48). The groups had similar median times to first successful trial of unassisted breathing (25 vs. 27 hours; p = 0.76), successful extubation (32 vs. 34 hours; p = 0.65), ICU discharge (3.0 days for both groups), and hospital discharge (27 vs. 29 days; p = 0.563). Five NO versus six control patients died during their hospital stay. Adjusting for age, sex, lung disease etiology, presence of pulmonary hypertension, and total ischemic time did not alter these results. In conclusion, we did not detect a significant effect of inhaled NO administered 10 minutes after reperfusion on physiologic variables or outcomes in lung transplant patients.
Authors:
Maureen O Meade; John T Granton; Andrea Matte-Martyn; Karen McRae; Bruce Weaver; Paula Cripps; Shaf H Keshavjee;
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Publication Detail:
Type:  Clinical Trial; 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 Jun 
Date Detail:
Created Date:  2003-05-28     Completed Date:  2003-06-24     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:  1483-9     Citation Subset:  AIM; IM    
Affiliation:
FRCPC, Toronto General Hospital, 200 Elizabeth Street, EN 10-220, Toronto, ON, M5G 2C4 Canada.
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Adult
Female
Humans
Intensive Care Units
Lung Transplantation*
Male
Nitric Oxide / administration & dosage*,  therapeutic use
Postoperative Complications / prevention & control*
Reperfusion
Reperfusion Injury / prevention & control*
Respiration, Artificial
Time Factors
Vasodilator Agents / administration & dosage*,  therapeutic use
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 10102-43-9/Nitric Oxide
Comments/Corrections
Comment In:
Am J Respir Crit Care Med. 2003 Jun 1;167(11):1463-4   [PMID:  12770851 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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