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Titolo:
Early administration of inhaled nitric oxide to children with acute respiratory distress syndrome and its effects on oxygenation and ventilator settings: prospective preliminary report of ten patients
Autore:
Fioretto, JR; Bonatto, RC; Ricchetti, SMQ; Carpi, MF; de Moraes, MA; Padovani, CR;
Indirizzi:
UNESP, Fac Med Botucatu, Botucatu Med Sch, Dept Pediat, BR-18618970 Sao Paulo, Brazil UNESP Sao Paulo Brazil BR-18618970 BCdiat, BR-18618970 Sao Paulo, Brazil Sao Paulo State Univ, Botucatu Inst Biosci, Dept Biostat, Sao Paulo, Brazil Sao Paulo State Univ Sao Paulo Brazil , Dept Biostat, Sao Paulo, Brazil
Titolo Testata:
CROATIAN MEDICAL JOURNAL
fascicolo: 5, volume: 42, anno: 2001,
pagine: 527 - 534
SICI:
0353-9504(200110)42:5<527:EAOINO>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
PERSISTENT PULMONARY-HYPERTENSION; RANDOMIZED CONTROLLED TRIAL; ACUTE LUNG INJURY; DOSE-RESPONSE; PERFUSION DISTRIBUTIONS; MECHANICAL VENTILATION; PEDIATRIC-PATIENTS; CLINICAL-TRIALS; RELAXING FACTOR; INTENSIVE-CARE;
Keywords:
child welfare; methemoglobin; multiple organ failure; nitric oxide; respiratory distress syndrome; ventilation, mechanical;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
62
Recensione:
Indirizzi per estratti:
Indirizzo: Fioretto, JR UNESP, Fac Med Botucatu, Botucatu Med Sch, Dept Pediat, BR-18618970 Sao Paulo, Brazil UNESP Sao Paulo Brazil BR-18618970 BC8970 Sao Paulo, Brazil
Citazione:
J.R. Fioretto et al., "Early administration of inhaled nitric oxide to children with acute respiratory distress syndrome and its effects on oxygenation and ventilator settings: prospective preliminary report of ten patients", CROAT MED J, 42(5), 2001, pp. 527-534

Abstract

Aim. To establish a protocol for the early introduction of inhaled nitric oxide (iNO) therapy in children with acute respiratory distress syndrome (ARDS) and to assess its acute and sustained effects on oxygenation and ventilator settings. Patients and Methods. Ten children with ARDS, aged 1 to 132 months (median, 11 months), with arterial saturation of oxygen <88% while receiving a fraction of inspired oxygen (FiO(2)) <greater than or equal to>0.6 and a positive end-expiratory pressure of greater than or equal to 10 cm H2O were included in the study. The acute response to iNO was assessed in a 4-hour dose-response test, and positive response was defined as an increase in the PaO2/FiO(2) ratio of 10 mmHg above baseline values. Conventional therapy was not changed during the test. In the following days, patients who had shown positive response continued to receive the lowest iNO dose. Hemodynamics, PaO2/FiO(2), oxygenation index, gas exchange, and methemoglobin levels were obtained when needed. Inhaled nitric oxide withdrawal followed predetermined rules. Results. At the end of the 4-hour test, all the children showed significant improvement in the PaO2/FiO(2) ratio (63.6%) and the oxygenation index (44.9%) compared with the baseline values. Prolonged treatment was associatedwith improvement in oxygenation, so that FiO(2) and peak inspiratory pressure could be quickly and significantly reduced., No toxicity from methemoglobin or nitrogen dioxide was observed. Conclusion. Administration of iNO to children is safe. iNO causes rapid and sustained improvement in oxygenation without adverse effects. Ventilator settings can safely be reduced during iNO treatment.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/07/20 alle ore 15:43:44