Nitric oxide therapy in COVID-19 patients with acute respiratory distress in intensive care unit

Year 2023, , 339 - 344, 27.10.2023

Fatih Seğmen , Duygu Kayar Çalılı , Güray Alp , Demet Bölükbaşı , Hülya Deniz Mısır , Elmas Uysal , Nalan Demir , Deniz Erdem

https://doi.org/10.38053/acmj.1317124

Abstract

Aims: The administration of inhaled nitric oxide (iNO) is a promising and new approach to treat viral load while increasing oxygenation directly. This research aimed to elucidate the clinical and laboratory response to the treatment of the patients diagnosed with Coronavirus disease-19 (COVID-19) in the intensive care unit (ICU) and followed up due to respiratory failure and given iNO.
Methods: A total of 46 individuals who were diagnosed with COVID-19 and developed severe respiratory failure were followed up with or without intubation, had previously received standard care were evaluated within the study’s scope. iNO initiation time in the ICU, whether the patients were intubated, clinical and laboratory parameters before and after iNO treatment were obtained from hospital records.
Results: A statistically significant difference has been achieved in arterial partial pressure of oxygen (PaO2), peripheral oxygen saturation (SpO2), and the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PaO2/FiO2) ratios before and after iNO (p<0.05). While significant differences were observed in oxygenation with iNO treatment, no significant differences were observed in other parameters. When iNO onset times were evaluated, it was determined that the initiation time of iNO treatment was significantly later in patients who died. The relationship between the duration of mechanical ventilation, the duration of stay in the ICU, and the onset of iNO was a statistically significant relationship between all measurements (p<0.05).
Conclusion: iNO has been suggested as an alternative rescue method before invasive treatment in guidelines, especially for the relief of hypoxemia. However, the effective dose and safety of iNO is still not clear.

Keywords

Nitric oxide, inhaled nitric oxide, COVID-19, acute respiratory distress syndrome, intensive care unit

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