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

Bredmose, Per P.; Buskop, Christian; Lømo, Anne Birthe

doi:10.1186/s13049-019-0602-x

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…Expected side effects such as systemic hypotension, bradycardia, pulmonary hypotension, kidney failure and methaemoglobinaemia, and platelet will be monitored and recorded as secondary endpoints. The dosage of 20 ppm is in accordance with previous trials, case reports and clinical experience and found to be an adequate balance between sufficient effect and potential side effects [6,7,[10][11][12]14].…”

Section: Plos Onesupporting

confidence: 65%

“…A recent systematic review concludes that there is currently insufficient evidence to support long-term iNO in hypoxic respiratory failure [6]. Nevertheless, iNO used as a temporary measure on certain indications is widespread in adult critical care [7,[9][10][11]. During the current epidemic, iNO with doses starting at 20 parts per million (ppm) has successfully been used as rescue therapy to increase arterial oxygenation in patients with severe Covid-19 related ARDS [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Plos Onesupporting

confidence: 65%

Section: Introductionmentioning

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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“…PAH is a serious, incurable cardiovascular disease with high mortality rate. There are several signaling pathways involved in regulation of hemodynamic changes using for therapeutic intervention in this clinical situation: prostaglandin one, with prostacyclin as a modeling substance, endothelin receptors, nitric oxide and cGMP pathway (with PDE type V inhibitors to increase intracellular concentration of this second messenger) [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

The Effects of Pulmonary Arterial Hypertension on the Heart Work Dynamics: Gender Differences

Kocić

Achranowicz

2019

BJSTR

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Aim:The aim of this paper was to find out possible changes of heart work dynamics induced by pulmonary artery hypertension in male and female rats. Materials and methods:Experiments were performed on the Wistar rats of both genders. Pulmonary hypertension (PAH) was induced by i.p. injection of monocrotaline (60 mg/kg B.W.) on day 0 to 21 days observational period. After that, animal was sacrificed, hearts removed and papillary muscles from right ventricle isolated. Velocity of heart contraction (+dF/dt) and relaxation (-dF/dt) were measured. Additionally, pathomorphologic analysis of lung blood vessels has been carried out.

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In-Hospital Outcomes of Patients With Pulmonary Hypertension and Cirrhosis: A 6-Year Population Cohort Study of Over One Million Patients

et al. 2020

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Introduction There is a paucity of data on the influence of sex, race, insurance, pulmonary hypertension-related complications, and cirrhosis-related complications on mortality, hospital length of stay (LOS), and total hospital charges. The aim of this study was to identify risk factors in a national population cohort (in the USA) admitted to hospital between 2012 and 2017. Methods All patients aged > 18 years with pulmonary hypertension and cirrhosis, who had been admitted to hospital between 2012 and 2017, were identified from the US Nationwide Inpatient Sample (NIS), a large publicly available all-payer inpatient care database in the USA. Multivariate regression analysis was used to estimate the odds ratios of in-hospital mortality, average length of hospital stay, and hospital charges, after adjusting for age, gender, race, primary insurance payer status, hospital type and size (number of beds), hospital region, hospital teaching status, and other demographic characteristics. Results Our study identified 1,111,594 patients who had been discharged from hospital from 2012 to 2017. Of these patients, 355,455 were admitted with pulmonary hypertension, with 9.8% having cirrhosis as a complication ( n = 34,986). The analysis revealed that patients with both pulmonary hypertension and cirrhosis compared to patients with only pulmonary hypertension experience increased mortality, hospital LOS, total hospital charges, and pulmonary hypertension-related and cirrhosis-related complications. Independent positive predictors of mortality were Asian/Pacific Islander race and "other" insurance status (worker’s compensation; other US health benefits plans [CHAMPUS/TRICARE, CHAMPVA, Title V]). Independent positive predictors of increased hospital LOS were black race and "other" patients (more than one race/mixed). Independent positive predictors of increased total hospital charges were male gender, Hispanic ethnicity, Asian/Pacific Islander race, and other insurance status. Pulmonary hypertension-related complications (cor pulmonale, pulmonary embolism, hemoptysis, cardiac arrest, atrial fibrillation, ventricular tachycardia) and cirrhosis-related complications (ascites, hepatorenal syndrome, hepatic encephalopathy, variceal bleeding, portal hypertension) were independent positive predictors of mortality, hospital LOS, and total hospital charges. Conclusions Patients with pulmonary hypertension and cirrhosis have increased mortality and hospital utilization compared to patients with only pulmonary hypertension. We identified key drivers for these outcomes. Targeted interventions, such as novel medications, right-to-left shunts, more evaluations for lung transplantation, and reversal of pulmonary vacular remodeling, are needed for the subgroups identified in this study in order to improve outcomes.

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

Cited by 4 publications

References 16 publications

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

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

The Effects of Pulmonary Arterial Hypertension on the Heart Work Dynamics: Gender Differences

In-Hospital Outcomes of Patients With Pulmonary Hypertension and Cirrhosis: A 6-Year Population Cohort Study of Over One Million Patients

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