Inhaled Nitric Oxide via High-Flow Nasal Cannula in Patients with Acute Respiratory Failure Related to COVID-19.
Publication/Presentation Date
1-1-2021
Abstract
INTRODUCTION: Limited evidence exists regarding use of inhaled nitric oxide (iNO) in spontaneously breathing patients. We evaluated the effectiveness of continuous iNO via high-flow nasal cannula (HFNC) in COVID-19 respiratory failure.
METHODS: We performed a multicenter cohort study of patients with respiratory failure from COVID-19 managed with HFNC. Patients were stratified by administration of iNO via HFNC. Regression analysis was used to compare the need for mechanical ventilation and secondary endpoints including hospital mortality, length of stay, acute kidney injury, need for renal replacement therapy, and need for extracorporeal life support.
RESULTS: A total of 272 patients were identified and 66 (24.3%) of these patients received iNO via HFNC for a median of 88 h (interquartile range: 44, 135). After 12 h of iNO, supplemental oxygen requirement was unchanged or increased in 52.7% of patients. Twenty-nine (43.9%) patients treated with iNO compared to 79 (38.3%) patients without iNO therapy required endotracheal intubation (
CONCLUSION: In patients with COVID-19 respiratory failure, iNO delivered via HFNC did not reduce oxygen requirements in the majority of patients or improve clinical outcomes. Given the observed association with increased length of stay, judicious selection of those likely to benefit from this therapy is warranted.
Volume
15
First Page
11795484211047065
Last Page
11795484211047065
ISSN
1179-5484
Published In/Presented At
Chandel, A., Patolia, S., Ahmad, K., Aryal, S., Brown, A. W., Sahjwani, D., Khangoora, V., Shlobin, O. A., Cameron, P. C., Singhal, A., Holtzclaw, A. W., Desai, M., Nathan, S. D., & King, C. S. (2021). Inhaled Nitric Oxide via High-Flow Nasal Cannula in Patients with Acute Respiratory Failure Related to COVID-19. Clinical medicine insights. Circulatory, respiratory and pulmonary medicine, 15, 11795484211047065. https://doi.org/10.1177/11795484211047065
Disciplines
Medicine and Health Sciences
PubMedID
34602831
Department(s)
Department of Medicine
Document Type
Article