Abstract
Purpose: Measure the effect of inhaled pulmonary vasodilators on gas exchange in mechanically ventilated patients with COVID-19.
Methods: A retrospective observational cohort study at three New York University Hospitals was performed including eighty-four mechanically ventilated SARS Cov-2 nasopharyngeal PCR positive patients, sixty nine treated with inhaled nitric oxide (iNO) and fifteen with inhaled epoprostenol (iEPO). The primary outcomes were change in P A O 2 :F I O 2 ratio, oxygenation Index (OI), and ventilatory ratio (VR) after initiation of inhaled pulmonary vasodilators.
Results: There was no significant change in P A O 2 :F I O 2 ratio after initiation of iNO (mean – 4.1, 95% CI -17.3-9.0, P = 0.54) or iEPO (mean – 3.4, 95% CI -19.7-12.9, P = 0.66), in OI after initiation of iNO (mean 2.1, 95% CI-0.04-4.2, P = 0.054) or iEPO (mean – 3.4, 95% CI -19.7-12.9, P = 0.75), or in VR after initiation of iNO (mean 0.17, 95% CI -0.03-0.36, P = 0.25) or iEPO (mean 0.33, 95% CI -0.0847-0.74, P = 0.11). P A O 2 :F I O 2 , OI and VR did not significantly change over a five day period starting the day prior to drug initiation in patients who received either iNO or iEPO assessed with a fixed effects model.
Conclusion: Inhaled pulmonary vasodilators were not associated with significant improvement in gas exchange in mechanically ventilated patients with COVID-19.
Keywords: ARDS; COVID-19; Epoprostenol; Inhaled nitric oxide; Respiratory failure; Ventilatory ratio.
【저자키워드】 COVID-19, ARDS, Respiratory failure, Inhaled nitric oxide, Ventilatory ratio., Epoprostenol, 【초록키워드】 nitric oxide, nasopharyngeal, Gas exchange, Patient, Inhaled, respiratory, university, New York, patients, retrospective, Oxygenation, index, Observational cohort study, Primary outcome, 95% CI, PCR positive, measure, ventilatory, mechanically ventilated, Effect, FIVE, significantly, nine, was performed, treated, fixed, mechanically ventilated patient, with COVID-19, 【제목키워드】 Gas exchange, retrospective cohort study, mechanically ventilated patient,