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Inhaled high dose nitric oxide is a safe and effective respiratory treatment in spontaneous breathing hospitalized patients with COVID-19 pneumonia.
Safaee Fakhr, Bijan; Di Fenza, Raffaele; Gianni, Stefano; Wiegand, Steffen B; Miyazaki, Yusuke; Araujo Morais, Caio C; Gibson, Lauren E; Chang, Marvin G; Mueller, Ariel L; Rodriguez-Lopez, Josanna M; Ackman, Jeanne B; Arora, Pankaj; Scott, Louie K; Bloch, Donald B; Zapol, Warren M; Carroll, Ryan W; Ichinose, Fumito; Berra, Lorenzo.
Afiliação
  • Safaee Fakhr B; Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
  • Di Fenza R; Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
  • Gianni S; Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
  • Wiegand SB; Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
  • Miyazaki Y; Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
  • Araujo Morais CC; Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
  • Gibson LE; Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
  • Chang MG; Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
  • Mueller AL; Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
  • Rodriguez-Lopez JM; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.
  • Ackman JB; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.
  • Arora P; Division of Cardiovascular Disease, University of Alabama at Birmingham, Tinsley Harrison Tower, Suite 311, 1900 University Boulevard, Birmingham, AL, 35233, USA.
  • Scott LK; Critical Care Medicine, Department of Medicine, LSU Health Shreveport, 1501 Kings Hwy, Shreveport, LA, 71103, USA.
  • Bloch DB; Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Center for Immunology and Inflammatory Diseases and Division of Rheumatology, Allergy, and Immunology, Depa
  • Zapol WM; Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
  • Carroll RW; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.
  • Ichinose F; Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
  • Berra L; Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Respiratory Care Services, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA. Electronic
Nitric Oxide ; 116: 7-13, 2021 11 01.
Article em En | MEDLINE | ID: mdl-34400339
ABSTRACT

BACKGROUND:

Inhaled nitric oxide (NO) is a selective pulmonary vasodilator. In-vitro studies report that NO donors can inhibit replication of SARS-CoV-2. This multicenter study evaluated the feasibility and effects of high-dose inhaled NO in non-intubated spontaneously breathing patients with Coronavirus disease-2019 (COVID-19).

METHODS:

This is an interventional study to determine whether NO at 160 parts-per-million (ppm) inhaled for 30 min twice daily might be beneficial and safe in non-intubated COVID-19 patients.

RESULTS:

Twenty-nine COVID-19 patients received a total of 217 intermittent inhaled NO treatments for 30 min at 160 ppm between March and June 2020. Breathing NO acutely decreased the respiratory rate of tachypneic patients and improved oxygenation in hypoxemic patients. The maximum level of nitrogen dioxide delivered was 1.5 ppm. The maximum level of methemoglobin (MetHb) during the treatments was 4.7%. MetHb decreased in all patients 5 min after discontinuing NO administration. No adverse events during treatment, such as hypoxemia, hypotension, or acute kidney injury during hospitalization occurred. In our NO treated patients, one patient of 29 underwent intubation and mechanical ventilation, and none died. The median hospital length of stay was 6 days [interquartile range 4-8]. No discharged patients required hospital readmission nor developed COVID-19 related long-term sequelae within 28 days of follow-up.

CONCLUSIONS:

In spontaneous breathing patients with COVID-19, the administration of inhaled NO at 160 ppm for 30 min twice daily promptly improved the respiratory rate of tachypneic patients and systemic oxygenation of hypoxemic patients. No adverse events were observed. None of the subjects was readmitted or had long-term COVID-19 sequelae.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia Viral / Respiração / Tratamento Farmacológico da COVID-19 / Hospitalização / Óxido Nítrico Tipo de estudo: Clinical_trials Limite: Humans Idioma: En Revista: Nitric Oxide Assunto da revista: BIOQUIMICA / QUIMICA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia Viral / Respiração / Tratamento Farmacológico da COVID-19 / Hospitalização / Óxido Nítrico Tipo de estudo: Clinical_trials Limite: Humans Idioma: En Revista: Nitric Oxide Assunto da revista: BIOQUIMICA / QUIMICA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos