Randomised trial of three doses of inhaled nitric oxide in acute respiratory distress syndrome.
Background-Inhaled nitric oxide (iNO) is a potential therapeutic agent for the management of acute respiratory distress syndrome (ARDS).
Concerns remain, however, regarding the potential toxicity from iNO and/or its oxidative derivatives and methaemoglobinaemia.
Aims-To determine the risk of toxicity from iNO, which includes worsening of lung injury, a prospective study evaluating the acute effects of three concentrations of iNO on gas exchange and haemodynamics in 12 children with ARDS was performed in a tertiary paediatric intensive care unit.
Intervention-iNO was administered for one hour at three concentrations (1,10, and 20 parts per million (ppm)) in a random order of possible dosing schedules to avoid dose accumulation bias.
Arterial blood gas, methaemoglobin concentrations, and haemodynamic parameters were obtained at baseline before commencement of iNO, at the end of each study hour, and after iNO was discontinued.
Nitric oxide and nitrogen dioxide concentrations were continuously monitored during the study.
INO significantly improved the oxygenation ratio (Pao2/Fio2) from a mean (SEM) baseline of 11.9 (1.7) kPa to 20 (3.9) kPa, 24 (4.5) kPa, and 21.6 (3.9) kPa at 1,10, and 20 ppm iNO, respectively.
There was no significant difference in the improvement in oxygenation achieved between the three concentrations.
Correspondingly, there was a significant improvement in oxygenation index (pre-iNO 28. (...)
Mots-clés Pascal : Insuffisance respiratoire, Aigu, Azote monoxyde, Effet concentration, Traitement, Toxicité, Oxygénation, Gaz sanguin, Hémodynamique, Etude statistique, Australie, Océanie, Nourrisson, Homme, Enfant, Appareil respiratoire pathologie, Unité soin intensif, Réanimation respiratoire
Mots-clés Pascal anglais : Respiratory failure, Acute, Nitric oxide, Concentration effect, Treatment, Toxicity, Oxygenation, Blood gas, Hemodynamics, Statistical study, Australia, Oceania, Infant, Human, Child, Respiratory disease, Intensive care unit, Respiratory intensive care
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0535885
Code Inist : 002B27B02. Création : 23/03/1999.