Chest
Efficacy of Inhaled Nitric Oxide in Children With ARDS
Section snippets
MATERIALS AND METHODS
This study was approved by the institutional review board at the Kumamoto University Hospital. Patients were enrolled after informed consent was obtained from their parents.
RESULTS
Seven children with severe ARDS, ranging from 2 months to 17 years of age, were studied (Table 1), including three boys and four girls. The ARDS score was ≥3.0 in each case. Three children had ARDS due to sepsis during therapies for tyrosinemia, acute leukemia, and acute hepatitis. Three had ARDS due to viral pneumonia and one due to a near-drowning. Duration between the time of the diagnosis of ARDS and initiation of NO inhalation ranged from 2 h to 5 days. The mean mortality risk estimated by
DISCUSSION
The major findings of the present study were that (1) children with severe ARDS had variable responses to iNO, (2) the magnitude of improvement in oxygenation correlated with the baseline PaO2/FIO2 ratio, and (3) improvements in arterial oxygenation could be observed with concentrations of iNO of ≤1 ppm.
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Cited by (43)
Surfactant Therapy for Acute Lung Injury and Acute Respiratory Distress Syndrome
2011, Critical Care ClinicsCitation Excerpt :As a representative example, the possible benefit of concurrent use of exogenous surfactant therapy with INO is discussed briefly later. Clinical studies have shown that INO alone improves arterial oxygenation and reduces pulmonary artery pressure in adults with ARDS202–210 and in infants or children with acute respiratory failure.261–266 The rationale for combination therapy with INO and exogenous surfactant is based on their complementary mechanisms of action in improving ventilation/perfusion matching and gas exchange.
ACUTE RESPIRATORY DISTRESS SYNDROME IN CHILDREN
2009, Feigin and Cherry's Textbook of Pediatric Infectious Diseases, Sixth EditionMicro-gas analysis system for measurement of nitric oxide and nitrogen dioxide: Respiratory treatment and environmental mobile monitoring
2007, Analytica Chimica ActaCitation Excerpt :In 1987, Palmer et al. discovered that nitric oxide (NO) has an endothelium-derived relaxing factor (EDRF) [1]. Recently, attention has been given to treatment with NO inhalation as an effective medical treatment for respiratory distress syndrome, especially for babies who have a high blood pressure disease in a lung [2]. Currently this treatment is performed in an intensive care unit (ICU) where NO gas from a heavy cylinder (normally 800 ppmv NO balanced with nitrogen) is diluted with air to be introduced to an artificial respiration apparatus.
Acute Respiratory Distress Syndrome in the Pediatric Patient
2006, Kendig's Disorders of the Respiratory Tract in ChildrenEffects of inhaled nitric oxide administration on early postoperative mortality in patients operated for correction of atrioventricular canal defects
2005, ChestCitation Excerpt :This study suggests that a correlation exists between treatment by iNO and survival in children operated for AV canal complicated by POPH crisis. Several clinical pediatric studies have reported favorable results in the treatment of POPH crisis with iNO5,6,8, 20-13 or in ARDS.24-26 Nevertheless, prospective randomized trials to substantiate mortality reduction are not available.
The Role of Inhaled Nitric Oxide and Heliox in the Management of Acute Respiratory Failure
2006, Respiratory Care Clinics of North AmericaCitation Excerpt :These reports can be divided into many areas of interest and patient population. More than 20 clinical trials of pediatric and adult patients with ARDS treated with iNO have been published [2,10–31]. Generally, 60% to 80% of ARDS patients respond to iNO with a 20% improvement in oxygenation and a 10% reduction in pulmonary artery pressure.
Manuscript received July 9, 1997; revision accepted February 26, 1998.
Supported by Grant-in Aid for Scientific Research No. 07457360, 09470333, and 09771172, Ministry of Education, Science and Culture, Japan.