Efficacy of Inhaled Nitric Oxide in Children With ARDS

Okamoto, Kazufumi; Hamaguchi, Masumitsu; Kukita, Ichiro; Kikuta, Koichi; Sato, Toshihide

doi:10.1378/chest.114.3.827

Cited by 40 publications

(26 citation statements)

References 33 publications

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“…However, we did not find statistically significant changes in PaCO 2 and PVRI after INO administration. Okamoto et al (14) found that the magnitude of the decrease in PaCO 2 during INO was remarkable in patients with high baseline PaCO 2 values. Puybasset et al (19) showed that INO reversed the increase in pulmonary vascular resistance induced by acute hypercarbia.…”

Section: Discussionmentioning

confidence: 99%

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Combination of Inhaled Nitric Oxide Therapy and Inverse Ratio Ventilation in Patients with Sepsis-Associated Acute Respiratory Distress Syndrome

Okamoto¹,

Kukita²,

Hamaguchi³

et al. 2000

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Inverse ratio ventilation (IRV) is a ventilatory technique that uses an inspiratory to expiratory ratio (I:E) greater than 1:1. We studied the effects of mechanical ventilation with an I:E of 1:3, 1:1, and 2:1 on arterial oxygenation in 10 patients with sepsis-associated acute respiratory distress syndrome (ARDS). At each I:E, patients received 0 and 4 ppm of inhaled nitric oxide (INO) in random order for 30 min. Respiratory and cardiovascular parameters were measured. Of the 10 patients studied, 7 responded to IRV and 3 did not. An increase in the I:E and the addition of INO significantly improved arterial oxygenation in the responders (p < 0. 0001 and p < 0.006, respectively). The combination of an increase in the I:E and INO had an additive effect on arterial oxygenation. The combined use of IRV and INO is a more effective method of avoiding hypoxemia than either INO or IRV alone.

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Section: Discussionmentioning

confidence: 99%

“…Associations were described between level of the baseline pulmonary vascular resistance (6), level of the baseline PaO 2 /FiO 2 (14), and use of phenylephrine (15) and the effect of INO on arterial oxygenation. We could not determine which factors were associated with responsiveness to INO.…”

Section: Discussionmentioning

confidence: 99%

Combination of Inhaled Nitric Oxide Therapy and Inverse Ratio Ventilation in Patients with Sepsis-Associated Acute Respiratory Distress Syndrome

Okamoto¹,

Kukita²,

Hamaguchi³

et al. 2000

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“…Abman et al, em 1994 34 , descreveram efeitos benéficos do gás sobre a oxigenação, HP e índice cardíaco em crianças com a síndrome. Posteriormente, estudos conduzidos em adultos 35,36 e em crianças 37,38 , enquanto confirmaram os efeitos benéficos imediatos, não foram capazes de demonstrar resposta prolongada da terapia com NOi. No entanto, Dobyns et al 39 observaram resposta prolongada ao NOi versus terapia com placebo em subgrupos de pacientes, aqueles com insuficiência respiratória mais grave (índice de oxigenação > 25) e nos pacientes imunodeprimidos.…”

Section: Hipertensão Pulmonar Persistente E Insuficiência Respiratóriunclassified

Inhaled nitric oxide in pediatrics

Fioretto

2003

J Pediatr (Rio J)

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ResumoObjetivo: Rever a literatura sobre óxido nítrico inalatório e descrever suas principais indicações clínicas em pediatria. Fontes dos dados:Revisão bibliográfica e seleção de publicações mais relevantes sobre óxido nítrico inalatório, utilizando a base de dados Medline (últimos dez anos) e a base de dados Cochrane de revisões sistemáticas. Síntese dos dados:A revisão incluiu os seguintes tópicos: introdução; metabolismo e efeitos biológicos; aplicações clínicas; dose, administração e retirada do gás; precações e efeitos adversos e contra-indicações. Quanto às aplicações clínicas, foram descritos o uso de óxido nítrico em hipertensão pulmonar persistente e insuficiência respiratória de recém-nascidos, síndrome do desconforto respiratório agudo, hipertensão pulmonar primária, cirurgia cardía-ca, doença pulmonar obstrutiva crônica, anemia falciforme e broncoespasmo. Conclusões:O óxido nítrico inalatório é um tratamento com amplas possibilidades de utilização em clínica pediátrica. Seu uso é seguro em ambiente de terapia intensiva sob monitorização rigorosa. Como vasodilatador pulmonar seletivo, o óxido nítrico tem efeitos benéficos sobre as trocas gasosas e ventilação. Estudos controlados que enfoquem a administração precoce do gás são necessários em muitas condições, principalmente na síndrome do desconforto respiratório agudo.J Pediatr (Rio J) 2003;79(Supl.2):S177-S186: Óxido nítrico inalatório, pediatria, hipertensão pulmonar, ventilação mecânica. AbstractObjective: To review the literature on inhaled nitric oxide and to describe its main clinical applications in pediatrics. Sources of data:A 10 year literature review with selection of the most important publications on inhaled nitric oxide, using the Medline and Cochrane Systematic Review databases. Summary of the findings:This review was organized as follows: introduction; metabolism and biological effects; clinical applications; dosage, gas administration and weaning; precautions and side-effects. Inhaled nitric oxide use was described in persistent pulmonary hypertension and hypoxia of the newborn, acute respiratory distress syndrome, primary pulmonary hypertension, heart surgery, chronic obstructive pulmonary disease, sickle cell anemia, and bronchospastic disease. Conclusions:Inhaled nitric oxide is a therapeutic approach with wide clinical applications in pediatrics. Its use is safe when administered in pediatric intensive care units under strict monitoring. As a pulmonary vasodilator, nitric oxide has beneficial effects on gas exchange and ventilation. Controlled trials, focusing on early gas administration should be performed under many clinical conditions, especially acute respiratory distress syndrome.J Pediatr (Rio J) 2003;79(Supl.2):S177-S186: Inhaled nitric oxide, pediatrics, pulmonary hypertension, mechanical ventilation. Uso do óxido nítrico em pediatria Inhaled nitric oxide in pediatricsJosé R. Fioretto* IntroduçãoEm 1980, Furchgott e Zawadzki 1 demonstraram que o relaxamento da aorta de coelhos em resposta à acetilcolina era dependente da ...

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“…Abman et al, in 1994, 34 described beneficial effects on oxygenation, PH and cardiac index in children with the syndrome. Later, studies conducted on adults 35,36 and children, 37,38 while confirming the immediate beneficial effects, were not capable of demonstrating a prolonged response to iNO therapy. Dobyns et al, 39 however, observed a prolonged response to iNO as compared to therapy with a placebo in subgroups of patients; those with the most serious respiratory failure (oxygenation index > 25) and among immunodepressed patients.…”

Section: Acute Respiratory Distress Syndromementioning

confidence: 99%

Uso do óxido nítrico em pediatria

Fioretto¹

2003

J. Pediatr. (Rio J.)

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Objective: To review the literature on inhaled nitric oxide and to describe its main clinical applications in pediatrics. Sources of data:A 10 year literature review with selection of the most important publications on inhaled nitric oxide, using the Medline and Cochrane Systematic Review databases. Summary of the findings:This review was organized as follows: introduction; metabolism and biological effects; clinical applications; dosage, gas administration and weaning; precautions and sideeffects. Inhaled nitric oxide use was described in persistent pulmonary hypertension and hypoxia of the newborn, acute respiratory distress syndrome, primary pulmonary hypertension, heart surgery, chronic obstructive pulmonary disease, sickle cell anemia, and bronchospastic disease. Conclusions:Inhaled nitric oxide is a therapeutic approach with wide clinical applications in pediatrics. Its use is safe when administered in pediatric intensive care units under strict monitoring. As a pulmonary vasodilator, nitric oxide has beneficial effects on gas exchange and ventilation. Controlled trials, focusing on early gas administration should be performed under many clinical conditions, especially acute respiratory distress syndrome.J Pediatr (Rio J) 2003;79(Suppl 2):S177-S186: Inhaled nitric oxide, pediatrics, pulmonary hypertension, mechanical ventilation.

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Efficacy of Inhaled Nitric Oxide in Children With ARDS

Cited by 40 publications

References 33 publications

Combination of Inhaled Nitric Oxide Therapy and Inverse Ratio Ventilation in Patients with Sepsis-Associated Acute Respiratory Distress Syndrome

Combination of Inhaled Nitric Oxide Therapy and Inverse Ratio Ventilation in Patients with Sepsis-Associated Acute Respiratory Distress Syndrome

Inhaled nitric oxide in pediatrics

Uso do óxido nítrico em pediatria

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