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D Trachsel1, M Rutishauser1, F Frei2

  • 1Abteilung für pädiatrische Intensivmedizin und Pneumologie, Universitäts-Kinderklinik Basel, , , , XX.

Monatsschrift Kinderheilkunde : Organ Der Deutschen Gesellschaft Fur Kinderheilkunde
|April 1, 2020
PubMed
Summary
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Inhaled nitric oxide (NO) improved oxygenation in most children with acute respiratory distress syndrome (ARDS). This treatment may stabilize patients during hypoxemic respiratory failure.

Area of Science:

  • Pediatric Critical Care
  • Respiratory Medicine
  • Pharmacology

Context:

  • Acute respiratory distress syndrome (ARDS) in children presents significant challenges.
  • Inhaled nitric oxide (iNO) is a therapeutic gas used to improve oxygenation.
  • Previous research on iNO in ARDS has yielded mixed results, particularly in pediatric populations.

Purpose:

  • To evaluate the acute effects of inhaled nitric oxide (iNO) on oxygenation and pulmonary vascular resistance in pediatric patients with virus-induced hypoxemic respiratory failure.
  • To assess the impact of varying iNO doses (20 ppm then 5 ppm) on oxygenation indices and arterial oxygen tension.

Summary:

  • This study examined 4 children (4-54 months) with acute, virus-induced hypoxemic respiratory failure.
  • Inhaled nitric oxide (iNO) administration led to dramatic oxygenation improvement in 3 out of 4 patients, reducing the oxygenation index by over 30%.
Keywords:
Key words ARDSNOPulmonary hypertensionRespiratory failureRespiratory syncytial virus

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  • One patient experienced no oxygenation improvement but showed a significant decrease in pulmonary vascular resistance.

    • Impact:

    • Inhaled nitric oxide (iNO) demonstrates potential as a supportive therapy to stabilize pediatric patients during the acute phase of hypoxemic respiratory failure.
    • While not impacting survival rates in prior studies, iNO's ability to improve oxygenation may be clinically justifiable.
    • Findings suggest iNO could be a valuable tool in managing severe respiratory distress in children, warranting further investigation.