A 10‐year retrospective study of interhospital patient transport using inhaled nitric oxide in <scp>N</scp>orway

Buskop, Christian; Bredmose, Per P.; Sandberg, Mårten

doi:10.1111/aas.12505

Cited by 11 publications

(6 citation statements)

References 13 publications

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“…Modern air ambulance services are able to provide advanced interventions during transport, including intensive care procedures, differentiated catecholamine therapy, volume resuscitation, modern ventilation strategies, ECMO, inhaled nitric oxide, or even the use of heart-assisted devices (e.g. like Impella®) during transport [ 12 – 15 ]. Several guidelines recommend the use of ECMO or inhaled nitric oxide in selected COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective

Hilbert-Carius

Braun²,

Abu‐Zidan

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background COVID-19, the pandemic caused by the severe acute respiratory syndrome coronavirus-2, is challenging healthcare systems worldwide. Little is known about problems faced by emergency medical services—particularly helicopter services—caring for suspected or confirmed COVID-19 patients. We aimed to describe the issues faced by air ambulance services in Europe as they transport potential COVID-19 patients. Methods Nine different HEMS providers in seven different countries across Europe were invited to share their experiences and to report their data regarding the care, transport, and safety measures in suspected or confirmed COVID-19 missions. Six air ambulance providers in six countries agreed and reported their data regarding development of special procedures and safety instructions in preparation for the COVID-19 pandemic. Four providers agreed to provide mission related data. Three hundred eighty-five COVID-19-related missions were analysed, including 119 primary transport missions and 266 interfacility transport missions. Results All providers had developed special procedures and safety instructions in preparation for COVID-19. Ground transport was the preferred mode of transport in primary missions, whereas air transport was preferred for interfacility transport. In some countries the transport of COVID-19 patients by regular air ambulance services was avoided. Patients in interfacility transport missions had a significantly higher median (range) NACA Score 4 (2-5) compared with 3 (1-7), needed significantly more medical interventions, were significantly younger (59.6 ± 16 vs 65 ± 21 years), and were significantly more often male (73% vs 60.5%). Conclusions All participating air ambulance providers were prepared for COVID-19. Safe care and transport of suspected or confirmed COVID-19 patients is achievable. Most patients on primary missions were transported by ground. These patients were less sick than interfacility transport patients, for whom air transport was the preferred method.

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Section: Discussionmentioning

confidence: 99%

Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective

Hilbert-Carius

Braun²,

Abu‐Zidan

et al. 2020

Scand J Trauma Resusc Emerg Med

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“…Such transports aren’t “just transport”, but “bringing the university hospital closer to the patient”. The Air Ambulance department at Oslo University Hospital has an already well-established practice for both initiation of iNO treatment as well as providing continuous iNO treatment during the retrieval phase [13].…”

Section: Discussionmentioning

confidence: 99%

Inhaled nitric oxide might be a contributing tool for successful resuscitation of cardiac arrest related to pulmonary hypertension

Bredmose

Buskop

Lømo³

2019

Scand J Trauma Resusc Emerg Med

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We describe a case where inhaled nitric oxide (iNO) was successfully initiated during cardiopulmonary resuscitation (CPR) in a younger patient with cardiac arrest related to pulmonary hypertension after disseminated intravascular coagulation (DIC) postpartum bleeding and hysterectomy. This case illustrates that iNO might be a potential lifesaving tool for resuscitation of patients with cardiac arrest related to pulmonary hypertension, for whom most other resuscitation strategies often are futile. Electronic supplementary material The online version of this article (10.1186/s13049-019-0602-x) contains supplementary material, which is available to authorized users.

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“…Power calculation. One previous study in a different setting has shown that 71% of patients respond to the treatment with an absolute increase in SpO 2 of >5 percentage points [23]. We assume a standard deviation of 10 percentage points, and a within subject correlation of 0.8 based on clinical experience.…”

Section: Discussionmentioning

confidence: 99%

Inhaled nitric oxide as temporary respiratory stabilization in patients with COVID-19 related respiratory failure (INOCOV): Study protocol for a randomized controlled trial

et al. 2022

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Background In March 2020, WHO announced the COVID-19 a pandemic and a major global public health emergency. Mortality from COVID-19 is rapidly increasing globally, with acute respiratory failure as the predominant cause of death. Many patients experience severe hypoxia and life-threatening respiratory failure often requiring mechanical ventilation. To increase safety margins during emergency anaesthesia and rapid sequence intubation (RSI), patients are preoxygenated with a closed facemask with high-flow oxygen and positive end-expiratory pressure (PEEP). Due to the high shunt fraction of deoxygenated blood through the lungs frequently described in COVID-19 however, these measures may be insufficient to avoid harmful hypoxemia. Preoxygenation with inhaled nitric oxide (iNO) potentially reduces the shunt fraction and may thus allow for the necessary margins of safety during RSI. Methods and design The INOCOV protocol describes a phase II pharmacological trial of inhaled nitric oxide (iNO) as an adjunct to standard of care with medical oxygen in initial airway and ventilation management of patients with known or suspected COVID-19 in acute respiratory failure. The trial is parallel two-arm, randomized, controlled, blinded trial. The primary outcome measure is the change in oxygen saturation (SpO2), and the null hypothesis is that there is no difference in the change in SpO2 following initiation of iNO. Trial registration EudraCT number 2020-001656-18; WHO UTN: U1111-1250-1698. Protocol version: 2.0 (June 25th, 2021).

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A 10‐year retrospective study of interhospital patient transport using inhaled nitric oxide in Norway

Abstract: Transporting patients on inhaled nitric oxide is an alternative in selected patients who would otherwise require extracorporeal membrane oxygenation during transport.

Cited by 11 publications

References 13 publications

Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective

Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective

Inhaled nitric oxide might be a contributing tool for successful resuscitation of cardiac arrest related to pulmonary hypertension

Inhaled nitric oxide as temporary respiratory stabilization in patients with COVID-19 related respiratory failure (INOCOV): Study protocol for a randomized controlled trial

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