吸入一氧化氮治疗 COVID-19 诱导的 ARDS 的效果如何——是否值得？
Effects of inhaled nitric oxide in COVID-19-induced ARDS - Is it worthwhile?
机构信息
Department of Anaesthesiology and Critical Care Medicine, University of Würzburg, Würzburg, Germany.
Department of Critical Care, Emergency Medicine and Anaesthesiology, ARDS/ECMO-Center, University of Southampton, Kassel, Germany.
出版信息
Acta Anaesthesiol Scand. 2021 May;65(5):629-632. doi: 10.1111/aas.13757. Epub 2020 Dec 20.
BACKGROUND
Changes in pulmonary hemodynamics and ventilation/perfusion were proposed as hallmarks of Coronavirus disease 2019 (COVID-19)-induced acute respiratory distress syndrome (ARDS). Inhaled nitric oxide (iNO) may overcome these issues and improve arterial oxygenation.
METHODS
We retrospectively analyzed arterial oxygenation and pulmonary vasoreactivity in seven COVID-19 ARDS patients receiving 20 ppm iNO for 15-30 minutes.
RESULTS
The inhalation of NO significantly improved oxygenation. All patients with severe ARDS had higher partial pressures of oxygen and reduced pulmonary vascular resistance. Significant changes in pulmonary shunting were not observed.
CONCLUSION
Overall, iNO could provide immediate help and delay respiratory deterioration in COVID-19-induced moderate to severe ARDS.
背景
肺血流动力学和通气/灌注的变化被认为是 2019 年冠状病毒病（COVID-19）引起的急性呼吸窘迫综合征（ARDS）的标志。吸入一氧化氮（iNO）可能克服这些问题并改善动脉氧合。
方法
我们回顾性分析了 7 例 COVID-19 ARDS 患者接受 20ppm iNO 吸入 15-30 分钟后的动脉氧合和肺血管反应性。
结果
NO 的吸入显著改善了氧合。所有严重 ARDS 患者的氧分压均升高，肺血管阻力降低。未观察到肺分流的显著变化。
结论
总之，iNO 可以为 COVID-19 引起的中重度 ARDS 提供即时帮助并延缓呼吸恶化。
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