Inhaled nitric oxide (iNO) is used as rescue therapy for severe acute respiratory distress syndrome (ARDS), but its dose-dependent effects on systemic inflammation and outcomes remain controversial. This study aimed to compare clinical outcomes between high- and low-dose iNO in adults with severe ARDS. In this single-center retrospective cohort study, 117 patients with severe ARDS (PaO₂/FiO₂ ≤100 mmHg) treated with iNO between January 2020 and July 2024 were categorized by the maximum iNO concentration received: high-dose (≥ 10 ppm, n = 59) and low-dose ( 0.7) for these parameters in identifying high-dose exposure. Kaplan-Meier analysis showed significantly worse 30-day survival in the high-dose group (Log-rank P = 0.019). In this retrospective cohort, high-dose iNO (≥ 10 ppm) was associated with exacerbated systemic inflammation, impaired coagulation function, greater organ dysfunction, and increased 30-day mortality compared to low-dose iNO in severe ARDS. These findings suggest cautious use of higher iNO concentrations, emphasizing monitoring of inflammatory and coagulation responses.
Bai et al. (Mon,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: