Nitric oxide: Clinical applications in critically ill patients.
Nitric Oxide
; 121: 20-33, 2022 04 01.
Artículo
en Inglés
| MEDLINE | ID: covidwho-1665319
ABSTRACT
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.
Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Vasodilatadores
/
Enfermedad Crítica
/
Hipertensión Pulmonar
/
Enfermedades del Recién Nacido
/
Óxido Nítrico
Tipo de estudio:
Estudio experimental
/
Estudio observacional
/
Estudio pronóstico
/
Ensayo controlado aleatorizado
/
Revisiones
Tópicos:
Covid persistente
Límite:
Adulto
/
Humanos
/
Recién Nacido
Idioma:
Inglés
Revista:
Nitric Oxide
Asunto de la revista:
Bioquímica
/
Química
Año:
2022
Tipo del documento:
Artículo
País de afiliación:
J.niox.2022.01.007
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