Respiratory failure & ventilation

High-Dose Inhaled Nitric Oxide in Acute Hypoxemic Respiratory Failure Due to Coronavirus Disease (COVID-19): A Multicenter Phase II Trial

Am J Respir Crit Care MedPublished Randomised controlled trial

Primary resultResult — go to the resultMean difference 39.1 mmHg 95% CrI 18.1–60.3

Authors' conclusion

The use of high-dose inhaled nitric oxide resulted in an improvement of PaO2/FiO2 at 48 hours compared with usual care in adults with acute hypoxemic respiratory failure due to COVID-19.

Study context

Population
Mechanically ventilated adults with COVID-19 pneumoniamodified ITT analysis
Participants
193 participants
Comparison
Inhaled nitric oxide 80 ppm for 48 hours vs usual care
Primary endpoint
Change in arterial oxygenation (PaO2/FiO2)
Follow-up
48 hours
Methodological detailsphase II, multicentre, single-blind, parallel-arm
  • Phase II
  • Multicentre
  • Single-blind
  • Parallel-arm

Primary result

As reported in the abstract

Mean difference

39.1 mmHg

95% CrI 18.1–60.3

By group

Inhaled nitric oxide vs Control
mean difference 39.1 mmHg (95% CrI 18.1–60.3)

Secondary outcomes

Time to reach target PaO2/FiO2 (sustained for at least 24 h) · CrI

mean difference 0.44 (23.63–4.53)

OutcomeInhaled nitric oxideControlRR (95% CrI)
Proportion attaining target PaO2/FiO2 · 28 daysCrI27.7%17.2%2.03 (1.11–3.86)

Duration of ventilation and mortality at 28 and 90 days

Did not differ

Safety

No serious adverse events reported

Original publication

High-Dose Inhaled Nitric Oxide in Acute Hypoxemic Respiratory Failure Due to COVID-19: A Multicenter Phase II Trial. Am J Respir Crit Care Med. Published 15 December 2023. doi:10.1164/rccm.202304-0637oc

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