Real-world use of inhaled nitric oxide therapy in patients with COVID-19 and mild-to-moderate acute respiratory distress syndrome

• DOI: 10.7573/dic.2022-1-4
• Publication Date: 2022-04-08T13:20:19Z
• Authors: Steven H Abman; Nicholas R Fox; M Ibrahim Malik; Sneha S Kelkar; Shelby L Corman; Sanika Rege; Jenna Bhaloo; Rachel Shah; Ren-Jay Shei; Dana Saporito; Nisreen Shamseddine; Erik DeBoer; George J Wan
• Keywords: acute respiratory distress syndrome (ards); real-world; 03 medical and health sciences; 0302 clinical medicine; covid-19; inhaled nitric oxide; Therapeutics. Pharmacology; RM1-950; p/f ratio; Original Research; 3. Good health

Inhaled nitric oxide (iNO) has been studied in patients with severe acute respiratory distress syndrome (ARDS) due to COVID-19 when it may be too late impact disease course. This article aims describe real-world iNO use and outcomes mild-to-moderate ARDS the United States.This was a retrospective medical chart review study that included who were ≥18 years old, hospitalized for COVID-19, met Berlin definition, received ≥24 hours continuously during hospitalization, had partial pressure of oxygen (PaO2)/fraction inspired (FiO2) ratio (P/F ratio) >100 ≤300 mmHg at initiation. Outcomes oxygenation parameters, physician-rated Clinical Global Impression-Improvement (CGI-I) scale scores, adverse events. Response defined as >20% improvement P/F ratio.Thirty-seven six sites included. A ≤100 most common reason exclusion (n=146; 83% excluded patients). The mean (SD) increased from 136.7 (34.4) baseline 140.3 (53.2) 48 151.8 (50.0) 72 after response rate 62% (n=23). During no patient experienced events, including methemoglobinaemia, airway injury, or worsening pulmonary oedema associated iNO. At discharge, 54.0% (n=20) improved remained stable according CGI-I.In ARDS, reported toxicity. provides additional evidence supporting favourable benefit-risk profile treatment infection.