Early administration of inhaled nitric oxide to children with acute respiratory distress syndrome and its effects on oxygenation and ventilator settings: prospective preliminary report of ten patients

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dc.contributor.authorFioretto, JR
dc.contributor.authorBonatto, Rossano César [UNESP]
dc.contributor.authorRicchetti, SMQ
dc.contributor.authorCarpi, Mario Ferreira [UNESP]
dc.contributor.authorde Moraes, M. A.
dc.contributor.authorPadovani, Carlos Roberto [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2014-05-20T13:37:52Z
dc.date.available2014-05-20T13:37:52Z
dc.date.issued2001-10-01
dc.description.abstractAim. To establish a protocol for the early introduction of inhaled nitric oxide (iNO) therapy in children with acute respiratory distress syndrome (ARDS) and to assess its acute and sustained effects on oxygenation and ventilator settings.Patients and Methods. Ten children with ARDS, aged 1 to 132 months (median, 11 months), with arterial saturation of oxygen <88% while receiving a fraction of inspired oxygen (FiO(2)) <greater than or equal to>0.6 and a positive end-expiratory pressure of greater than or equal to 10 cm H2O were included in the study. The acute response to iNO was assessed in a 4-hour dose-response test, and positive response was defined as an increase in the PaO2/FiO(2) ratio of 10 mmHg above baseline values. Conventional therapy was not changed during the test. In the following days, patients who had shown positive response continued to receive the lowest iNO dose. Hemodynamics, PaO2/FiO(2), oxygenation index, gas exchange, and methemoglobin levels were obtained when needed. Inhaled nitric oxide withdrawal followed predetermined rules.Results. At the end of the 4-hour test, all the children showed significant improvement in the PaO2/FiO(2) ratio (63.6%) and the oxygenation index (44.9%) compared with the baseline values. Prolonged treatment was associated with improvement in oxygenation, so that FiO(2) and peak inspiratory pressure could be quickly and significantly reduced., No toxicity from methemoglobin or nitrogen dioxide was observed.Conclusion. Administration of iNO to children is safe. iNO causes rapid and sustained improvement in oxygenation without adverse effects. Ventilator settings can safely be reduced during iNO treatment.en
dc.description.affiliationUNESP, Fac Med Botucatu, Botucatu Med Sch, Dept Pediat, BR-18618970 São Paulo, Brazil
dc.description.affiliationSão Paulo State Univ, Botucatu Inst Biosci, Dept Biostat, São Paulo, Brazil
dc.description.affiliationUnespUNESP, Fac Med Botucatu, Botucatu Med Sch, Dept Pediat, BR-18618970 São Paulo, Brazil
dc.description.affiliationUnespSão Paulo State Univ, Botucatu Inst Biosci, Dept Biostat, São Paulo, Brazil
dc.format.extent527-534
dc.identifierhttp://www.cmj.hr/2001/42/5/11596168.htm
dc.identifier.citationCroatian Medical Journal. Zagreb: Medicinska Naklada, v. 42, n. 5, p. 527-534, 2001.
dc.identifier.fileWOS000171971600008.pdf
dc.identifier.issn0353-9504
dc.identifier.lattes0246391303241376
dc.identifier.lattes8727897080522289
dc.identifier.lattes3929692206834380
dc.identifier.orcid0000-0002-0648-876X
dc.identifier.urihttp://hdl.handle.net/11449/13123
dc.identifier.wosWOS:000171971600008
dc.language.isoeng
dc.publisherMedicinska Naklada
dc.relation.ispartofCroatian Medical Journal
dc.relation.ispartofjcr1.422
dc.relation.ispartofsjr0,463
dc.rights.accessRightsAcesso aberto
dc.sourceWeb of Science
dc.subjectchild welfarept
dc.subjectmethemoglobinpt
dc.subjectmultiple organ failurept
dc.subjectnitric oxidept
dc.subjectrespiratory distress syndromept
dc.subjectventilation, mechanicalpt
dc.titleEarly administration of inhaled nitric oxide to children with acute respiratory distress syndrome and its effects on oxygenation and ventilator settings: prospective preliminary report of ten patientsen
dc.typeArtigo
dcterms.licensehttp://www.cmj.hr/
dcterms.rightsHolderMedicinska Naklada
unesp.author.lattes0246391303241376[2]
unesp.author.lattes8727897080522289[6]
unesp.author.lattes3929692206834380
unesp.author.orcid0000-0002-7719-9682[6]
unesp.author.orcid0000-0002-0648-876X[2]
unesp.campusUniversidade Estadual Paulista (Unesp), Instituto de Biociências, Botucatupt
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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