Inhalation therapy with high doses of nitric oxide in a comorbid patient with COVID-19: A clinical case

Каменщиков, Н. О.; Кузнецов, М. С.; Diakova, M. L.; Podoksenov, Yu. K.; Kalashnikova, T. P.; Tyo, M. A.; Churilina, E. A.; Kozlov, B. N.

doi:10.29001/2073-8552-2022-37-4-180-187

SJCEM

2023

DOI: 10.29001/2073-8552-2022-37-4-180-187

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Inhalation therapy with high doses of nitric oxide in a comorbid patient with COVID-19: A clinical case

Н. О. Каменщиков

М. С. Кузнецов

M. L. Diakova

et al.

Abstract: The article describes a clinical case of inhalation therapy with high doses of nitric oxide (NO) in a comorbid patient with a severe course of COVID-19. An air stream containing NO was generated using the PLAZON device. High-dose NO inhalation therapy was administered as a life-saving option due to the lack of effect from treatment delivered in accordance with the current national clinical guidelines for the treatment of COVID-19. The safety and clinical efficacy of the technique was demonstrated.

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2024

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Cited by 2 publications

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Antibacterial Effect of Nitric Oxide on the Causative Agents of Hospital-Acquired Pneumonia (Experimental Study)

Kalashnikova,

Arsenyeva,

Kamenshchikov

et al. 2024

Obŝaâ reanimatologiâ

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The aim of the study was to evaluate the antimicrobial effect of single and repeated nitric oxide (NO) exposure on the major pathogens of nosocomial pneumonia isolated from the sputum of cardiac surgery patients.Materials and Methods. A 24-hour culture of microorganisms from pan-resistant isolates of Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii, and Klebsiella pneumoniae from the sputum of inpatient cardiac surgery patients with nosocomial pneumonia, as well as strains of P. aeruginosa and E. coli from the American Type Culture Collection (ATCC), were exposed to 200 ppm NO (experimental sample) or medical air (control sample) in a sealed chamber for 30 minutes. After a single or 4 repeated gas exposure at 4 h intervals, Petri dishes were placed in a thermostat at 37°C and the results were evaluated at 24 and 48 h or at 12, 24, 36 and 48 h, respectively. Grown colonies were counted using an automated colony counter and recorded as CFU/mL.Results. No growth of clinical isolates of P. aeruginosa and E. coli was observed 24 and 48 h after a single exposure to NO. Growth of A. baumannii was lower compared to controls at 24 h but continued at 48 h. No effect of a single exposure to 200 ppm NO on other microorganisms was observed. After 4 exposures to NO, the growth of ATCC E. coli was not detected, the growth of other experimental strains was significantly lower compared to the control (P<0.05).Conclusion. Our results provide a rationale for the use of multiple intermittent inhalation of 220 ppm NO for the treatment of patients with hospital-acquired bacterial pneumonia.

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Antibacterial Effect of Nitric Oxide on the Causative Agents of Hospital-Acquired Pneumonia (Experimental Study)

Kalashnikova,

Arsenyeva,

Kamenshchikov

et al. 2024

Obŝaâ reanimatologiâ

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Use of inhaled nitric oxide in COVID-19

Nguyen,

Pozdnyakova,

Baranova

et al. 2024

Pulʹmonologiâ (Mosk.)

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Inhaled nitric oxide (iNO) is being considered as a potential therapeutic intervention for COVID-19 and post-COVID syndrome due to its various mechanisms such as vasodilation, antiviral activity, antithrombotic and anti-inflammatory effects. There is currently a lack of information on patient selection criteria, optimal dosing, duration and timing of administration, and methods of administration. These factors are of substantial importance for the efficacy of iNO therapy.Aim. To discuss the physiological basis of using inhaled nitric oxide for treating patients with COVID-19 and post-COVID syndrome, analyze the research findings, and present the achievements in nitric oxide synthesis technology in medicine.Conclusion. The early initiation and use of high-dose iNO appears to be an effective and safe treatment strategy for patients with COVID-19, as it targets the basic pathological mechanisms of the disease. iNO may also be a promising therapeutic option for patients with post-COVID syndrome. However, the optimal dosing regimen, continuous or intermittent, warrants further investigation. Recent advances in nitric oxide synthesis technology are of great significance for the broad practical application of iNO therapy.

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Inhalation therapy with high doses of nitric oxide in a comorbid patient with COVID-19: A clinical case

Cited by 2 publications

References 17 publications

Antibacterial Effect of Nitric Oxide on the Causative Agents of Hospital-Acquired Pneumonia (Experimental Study)

Antibacterial Effect of Nitric Oxide on the Causative Agents of Hospital-Acquired Pneumonia (Experimental Study)

Use of inhaled nitric oxide in COVID-19

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