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VOLUME 13 , ISSUE 3 ( July-September, 2024 ) > List of Articles

Original Article

Prognostic Value of Response to Inhaled Nitric Oxide Administration in Patients with Acute Respiratory Distress Syndrome Related to Severe Acute Respiratory Syndrome Coronavirus 2 Infection

Pasquale Baratta, Francesco De Sensi, Alberto Cresti, Bruno Sposato, Rosa Buontempo, Genni Spargi, Ugo Limbruno

Keywords : Acute respiratory distress syndrome, Coronavirus disease 2019 infection, Intensive care unit

Citation Information : Baratta P, De Sensi F, Cresti A, Sposato B, Buontempo R, Spargi G, Limbruno U. Prognostic Value of Response to Inhaled Nitric Oxide Administration in Patients with Acute Respiratory Distress Syndrome Related to Severe Acute Respiratory Syndrome Coronavirus 2 Infection. Indian J Respir Care 2024; 13 (3):188-196.

DOI: 10.5005/jp-journals-11010-1134

License: CC BY-NC 4.0

Published Online: 30-09-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Background: The role of inhaled nitric oxide (iNO) in managing acute respiratory distress syndrome COVID-19 related (C-ARDS) is debatable. The study aimed to analyze the effect of iNO administration in patients with persistent severe hypoxia and intensive care unit (ICU) mortality. Materials and methods: This retrospective study included 196 consecutive critically ill patients with C-ARDS admitted to ICU from 1 October 2020 to 31 October 2021. Results: Of these patients, 28% had received iNO. Twenty-four (44.4%) were responders. Kaplan–Meier plot shows mortality was higher in nonresponders (86.6 vs 25.0%). Nonresponse to iNo was the most important predictive value (p = 0.01). The receiver operating characteristic (ROC) curve for a percentage increase in partial pressure of oxygen (PaO2) from baseline confirmed that it had a higher predictive value for inhospital survival. A value of 19% can predict the death event with a sensitivity of 81.8% and a specificity of 81.2%. Conclusion: Therefore, we propose to use iNO as a vasoreactivity test for prognostic stratification in patients with persistent severe hypoxia.

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