Koyfman Leonid, Simchon Omri, Koyfman Anna, Mushaev Shoshana, Gruenbaum Benjamin F, Gal Ron, Friger Michael, Arotsker Natan, Zlotnik Alexander, Klein Moti, Brotfain Evgeni
Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Department of Radiology, Meir Medical Center, Kfar Saba, Israel.
Crit Care Res Pract. 2021 May 5;2021:6633210. doi: 10.1155/2021/6633210. eCollection 2021.
Critically ill patients with severe hypoxemia are often treated in the intensive care unit (ICU) with inhaled nitric oxide (iNO). These patients are at higher risk when they require intrahospital transportation. In this study, we collected clinical and laboratory data from 221 patients who were hospitalized in the general ICU and treated with iNO at Soroka Medical Center, Israel, between January 2010 and December 2019. We retrospectively compared the 65 patients who received iNO during intrahospital transportation to the 156 patients who received iNO without transportation. Among critically ill patients who were transported while being administered iNO, only one patient had an adverse event (atrial fibrillation) on transport. We found that maximal iNO dosage during ICU stay, duration of mechanical ventilation, and percent of vasopressor support were the only independent risk factors for ICU mortality in both study groups. No difference in primary outcome of ICU mortality rate was found between the critically ill patients treated with iNO during intrahospital transportation and those who were treated with iNO but not transported during the ICU stay. We anticipate that this study will advise clinical decision-making in the ICU, especially when treating patients who are administered iNO.
患有严重低氧血症的重症患者常在重症监护病房（ICU）接受吸入一氧化氮（iNO）治疗。这些患者在需要院内转运时风险更高。在本研究中，我们收集了2010年1月至2019年12月期间在以色列索罗卡医疗中心综合ICU住院并接受iNO治疗的221例患者的临床和实验室数据。我们回顾性地比较了65例在院内转运期间接受iNO治疗的患者和156例未转运接受iNO治疗的患者。在接受iNO治疗时进行转运的重症患者中，只有1例患者在转运过程中出现不良事件（房颤）。我们发现，两个研究组中，ICU住院期间的最大iNO剂量、机械通气持续时间和血管升压药支持百分比是ICU死亡率的唯一独立危险因素。在院内转运期间接受iNO治疗的重症患者与在ICU住院期间接受iNO治疗但未转运的患者之间，ICU死亡率的主要结局没有差异。我们预计这项研究将为ICU的临床决策提供建议，尤其是在治疗接受iNO治疗的患者时。
