医学
体外膜肺氧合
肺动脉高压
重症监护医学
临床试验
观察研究
随机对照试验
一氧化氮
缺氧性肺血管收缩
呼吸衰竭
麻醉
心脏病学
内科学
作者
Simone Redaelli,Aurora Magliocca,Rajeev Malhotra,Giuseppe Ristagno,Giuseppe Citerio,Lorenzo Berra,Emanuele Rezoagli
出处
期刊:Nitric Oxide
[Elsevier]
日期:2022-04-01
卷期号:121: 20-33
被引量:22
标识
DOI:10.1016/j.niox.2022.01.007
摘要
Inhaled nitric oxide (iNO) acts as a selective pulmonary vasodilator and it is currently approved by the FDA for the treatment of persistent pulmonary hypertension of the newborn. iNO has been demonstrated to effectively decrease pulmonary artery pressure and improve oxygenation, while decreasing extracorporeal life support use in hypoxic newborns affected by persistent pulmonary hypertension. Also, iNO seems a safe treatment with limited side effects. Despite the promising beneficial effects of NO in the preclinical literature, there is still a lack of high quality evidence for the use of iNO in clinical settings. A variety of clinical applications have been suggested in and out of the critical care environment, aiming to use iNO in respiratory failure and pulmonary hypertension of adults or as a preventative measure of hemolysis-induced vasoconstriction, ischemia/reperfusion injury and as a potential treatment of renal failure associated with cardiopulmonary bypass. In this narrative review we aim to present a comprehensive summary of the potential use of iNO in several clinical conditions with its suggested benefits, including its recent application in the scenario of the COVID-19 pandemic. Randomized controlled trials, meta-analyses, guidelines, observational studies and case-series were reported and the main findings summarized. Furthermore, we will describe the toxicity profile of NO and discuss an innovative proposed strategy to produce iNO. Overall, iNO exhibits a wide range of potential clinical benefits, that certainly warrants further efforts with randomized clinical trials to determine specific therapeutic roles of iNO.
科研通智能强力驱动
Strongly Powered by AbleSci AI