Department of Pharmacy, Brigham and Women's Hospital, Boston, MA 02115.
J Crit Care. 2013 Oct;28(5):844-8. doi: 10.1016/j.jcrc.2013.03.006. Epub 2013 May 14.
The purpose of this is to compare efficacy, safety, and cost outcomes in patients who have received either inhaled epoprostenol (iEPO) or inhaled nitric oxide (iNO) for hypoxic respiratory failure.
This is a retrospective, single-center analysis of adult, mechanically ventilated patients receiving iNO or iEPO for improvement in oxygenation.
We evaluated 105 mechanically ventilated patients who received iEPO (52 patients) or iNO (53 patients) between January 2009 and October 2010. Most patients received therapy for acute respiratory distress syndrome (iNO 58.5% vs iEPO 61.5%; P=.84). There was no difference in the change in the partial pressure of arterial O2/fraction of inspired O2 ratio after 1 hour of therapy (20.58±91.54 vs 33.04±36.19 [P=.36]) in the iNO and iEPO groups, respectively. No difference was observed in duration of therapy (P=.63), mechanical ventilation (P=.07), intensive care unit (P=.67), and hospital lengths of stay (P=.26) comparing the iNO and iEPO groups. No adverse events were attributed to either therapy. Inhaled nitric oxide was 4.5 to 17 times more expensive than iEPO depending on contract pricing.
We found no difference in efficacy and safety outcomes when comparing iNO and iEPO in hypoxic, critically ill patients. Inhaled epoprostenol is associated with less drug expenditure than iNO.
本研究旨在比较接受吸入性前列环素（iEPO）或吸入性一氧化氮（iNO）治疗缺氧性呼吸衰竭患者的疗效、安全性和成本结果。
这是一项回顾性、单中心分析，纳入了接受 iNO 或 iEPO 治疗以改善氧合的成年机械通气患者。
我们评估了 2009 年 1 月至 2010 年 10 月期间接受 iEPO（52 例）或 iNO（53 例）治疗的 105 例机械通气患者。大多数患者接受治疗的原因是急性呼吸窘迫综合征（iNO 为 58.5%，iEPO 为 61.5%；P=.84）。治疗 1 小时后，动脉氧分压/吸入氧分数比值的变化在 iNO 组和 iEPO 组之间无差异（分别为 20.58±91.54 和 33.04±36.19 [P=.36]）。两组之间的治疗持续时间（P=.63）、机械通气（P=.07）、重症监护病房（P=.67）和住院时间（P=.26）无差异。两种治疗均未观察到不良反应。根据合同定价，吸入性一氧化氮的价格比 iEPO 高 4.5 至 17 倍。
在比较缺氧性危重病患者的 iNO 和 iEPO 时，我们未发现疗效和安全性结果存在差异。吸入前列环素与 iNO 相比，药物支出较少。
