Inhaled nitric oxide in patients with pulmonary embolism.

ABSTRACT

OBJECTIVE: To describe the use of inhaled nitric oxide (NO) in four patients with severe pulmonary embolism. SETTING: The intensive care unit (ICU) of a university teaching hospital. PATIENTS Four patients with severe pulmonary embolism on the basis of clinical, haemodynamic or blood-gas parameters received NO by inhalation either during spontaneous respiration (two cases) or while mechanically ventilated (two cases). INTERVENTIONS: Conventional management of pulmonary embolism in addition to the use of inhaled NO. MEASUREMENTS AND RESULTS: Description of clinical course, haemodynamic and gas-exchange data. Dose-response data are also described for three patients. CONCLUSIONS: We reported four cases of pulmonary embolism where the administration of inhaled NO resulted in an improvement in pulmonary haemodynamic and gas-exchange parameters. Two patients were weaned from NO and survived until discharged from the ICU. Inhaled NO might be a useful adjunct in pulmonary embolism to improve stability of the patient prior to thrombolysis or surgery.