Randomised controlled trials of inhaled nitric oxide (NO) in patients with ARDS
| Author | No of patients | Diagnosis | Blinded | Inhaled NO dose (ppm) | Duration | Outcome |
|---|---|---|---|---|---|---|
| Lundin et al (1999)69 | 260 | ALI (American-European Consensus Conference) and 18-96 hours ventilation with Pao2/Fio2 <22 kPa, PEEP at least 5 cm H2O, mean airway pressure >10 cm H2O and I:E 1:2–2:1 | No | 2–40 | 30 days | 180 randomised responded to NO. The frequency of reversal of ALI did not differ from controls. Development of severe respiratory failure less (2.2% v 10.3%) in NO treated group. Mortality not altered (44% v 40% control). |
| Dellinger et al (1998)11 | 177 | ARDS (American-European Consensus Conference) within 72 hours of onset and PEEP at least 8 cm H2O and Fio2 >0.5 | Yes | 1.25–80 | 28 days | Pao2 increased >20% in first 4 hours in 60% of patients treated with NO and 24% of controls. Fio2 and intensity of ventilation could be reduced in first 4 days. No difference in mortality (30% v 32–38% in NO treated groups). |
| Michael et al (1998)13 | 40 | ARDS (American-European Consensus Conference) and Fio2 at least 0.8 for 12 hours or 0.65 for 24 hours | No | 5–20 | 3 days | NO improved Pao2/Fio2 by at least 20% and allowed a decrease in Fio2 of at least 0.15 only in the first 24 hours in more treated patients than controls. |
| Troncy (1998)14 | 30 | Murray score at least 2.5 | No | 0.5–40 | 30 days | NO improved oxygenation only in the first 24 hours in more treated patients than controls. Mortality (60% v 67% in control) not altered. |