Respiratory failure & ventilation
Inhaled nitric oxide in patients with acute respiratory distress syndrome caused by COVID-19: treatment modalities, clinical response, and outcomes
Authors' conclusion
Our study reports the benefits of iNO in improving arterial oxygenation in C-ARDS patients.
Study context
- Population
- Patients with COVID-19-related ARDS (C-ARDS) treated with inhaled nitric oxide (iNO), France, February–December 202022.3% female
- Participants
- 300 patients
- Exposure
- iNO responders vs non-responders
- Outcome
- iNO response (PaO2/FiO2 ratio improving by 20% or more)
- Follow-up
- 6 h from iNO initiation
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Responders (PaO2/FiO2 improving by ≥20%) · 6 h
Responders
45.7%
Observational data: associations, not effects.
Further findings
| Outcome | Values | aOR (95% CI) | P value | |
|---|---|---|---|---|
| Mortality, refractory ARDS no longer ECMO eligible vs remained ECMO eligible (subgroup)After confounder adjustment | 0.23 (0.06–0.89) | P = 0.03 | ||
| 0.050.21520Adjusted odds ratio (log scale) |
| Outcome | Values |
|---|---|
| Refractory ARDS (ECMO criteria before iNO): no longer fulfilling ECMO criteria after 6 h of iNO (subgroup) | Refractory ARDS 51.6% |
- Refractory ARDS (ECMO criteria before iNO): no longer fulfilling ECMO criteria after 6 h of iNO (subgroup): 62 patients with refractory ARDS
Crude mortality, responders at 6 h vs counterparts
- Not significantly different
iNO treatment duration and dosage
- Median duration of iNO treatment (days)
- 2.8 (1.1-5.5)
- Median dosage at initiation (ppm)
- 10 (7-13)
Original publication
Inhaled nitric oxide in patients with acute respiratory distress syndrome caused by COVID-19: treatment modalities, clinical response, and outcomes. Ann Intensive Care. Published 27 June 2023. doi:10.
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