Combined Effects of Inhaled Nitric Oxide and Positive End-Expiratory Pressure During Mechanical Ventilation in Acute Respiratory Distress Syndrome

• Published in: Artificial organs Vol. 24; no. 5; pp. 390 - 395
• Main Authors: Okamoto, Kazufumi, Kukita, Ichiro, Hamaguchi, Masamichi, Motoyama, Takeshi, Muranaka, Hiroyuki, Harada, Toshikazu
• Format: Journal Article
• Language: English
• Published: Boston, MA, USA Blackwell Science Inc 01.05.2000
• Subjects: Acute respiratory distress syndrome; Administration, Inhalation; Adolescent; Adult; Aged; Aged, 80 and over; Analysis of Variance; Blood Pressure - drug effects; Bronchodilator Agents - administration & dosage; Bronchodilator Agents - therapeutic use; Carbon Dioxide - blood; Cardiac Output - drug effects; Central Venous Pressure - drug effects; Female; Humans; Male; Mechanical ventilation; Middle Aged; Nitric oxide; Nitric Oxide - administration & dosage; Nitric Oxide - therapeutic use; Oxygen - blood; Oxygen Consumption - drug effects; Oxygenation; Positive end-expiratory pressure; Positive-Pressure Respiration; Pulmonary Gas Exchange - drug effects; Pulmonary Wedge Pressure - drug effects; Respiration - drug effects; Respiration, Artificial; Respiratory Distress Syndrome, Adult - drug therapy; Respiratory Distress Syndrome, Adult - therapy; Vascular Resistance - drug effects
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1046/j.1525-1594.2000.06496-3.x

: We studied the combined effects of inhaled nitric oxide (INO) and positive end expiratory pressure (PEEP) during mechanical ventilation in patients with acute respiratory distress syndrome (ARDS). Eleven patients received 0 and 4 parts per million of INO in random order for 30 min at PEEP levels of 0, 5, and 10 cm H2O. Respiratory and cardiovascular parameters were measured. The addition of INO and PEEP significantly improved arterial oxygenation (p < 0.005 and p < 0.0001, respectively). The combined effect of INO and PEEP on arterial oxygenation was remarkable during 10 cm H2O PEEP. There was synergistic effect on arterial oxygenation by combining INO and 10 cm H2O PEEP. The present study showed that the combination of INO and 10 cm H2O PEEP enhanced arterial oxygenation in patients with ARDS.