Intensive Care Unit and Regional ECMO Referral Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
Intensive Care Unit and Regional ECMO Referral Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
J Crit Care. 2022 Dec;72:153987. doi: 10.1016/j.jcrc.2022.153987. Epub 2022 Feb 2.
To assess the effects of inhaled Nitric Oxide (iNO) on right ventricle dimension and function and systolic pulmonary arterial pressures in severe Acute Respiratory Distress (ARDS) due to Sars-Cov2 (COVID) infection.
We assessed the effects of iNO on right ventricle dimension and function and systolic pulmonary arterial pressures in 12 consecutive COVID-related ARDS patients by means of serial echocardiographic exams (baseline, 12 and 24 h since iNO start).
Inhaled NO administration did not influence systolic pulmonary arterial pressures nor RV dimension and function. No changes were detectable in ventilatory data with iNO administration. Considering the negligible effect on oxygenation, iNO use was discontinued in all cases.
In COVID-related severe ARDS iNO administrated as rescue therapy is not able to ameliorate oxygenation nor pulmonary hypertension, as assessed by serial echocardiograms. This finding may be explained by the diffuse loss of hypoxic pulmonary vasoconstriction with increased perfusion around alveolar consolidations which characterizes COVID-related severe ARDS.
评估吸入一氧化氮（iNO）对严重急性呼吸窘迫综合征（ARDS）患者右心室大小和功能以及收缩期肺动脉压的影响，这些患者是由于 SARS-CoV2（COVID）感染所致。
我们通过连续的超声心动图检查（基线、iNO 开始后 12 小时和 24 小时）评估了 12 例连续 COVID 相关 ARDS 患者的 iNO 对右心室大小和功能以及收缩期肺动脉压的影响。
吸入 NO 给药并未影响收缩期肺动脉压或 RV 大小和功能。iNO 给药后通气数据无变化。考虑到对氧合作用的影响可以忽略不计，所有患者均停止使用 iNO。
在 COVID 相关严重 ARDS 中，作为抢救治疗的 iNO 给药不能改善氧合作用或肺动脉高压，这可以通过连续超声心动图评估。这一发现可能是由于 COVID 相关严重 ARDS 中肺泡实变周围灌注增加导致缺氧性肺血管收缩弥漫性丧失所致。
