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April 13, 2013Emergency Medicine Journal

Pilot study of a protocol to administer inhaled nitric oxide to treat severe acute submassive pulmonary embolism

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Why the study?

Does inhaled nitric oxide improve dyspnoea and haemodynamics in patients with severe acute submassive pulmonary embolism?

Population

8 patients with CT-demonstrated, submassive pulmonary embolism and moderate to severe dyspnoea, recruited…

Design

Case_series

Follow-up

155 minutes

Authors

JKJeffrey A. KlineJHJackeline HernandezJGJohn S. Garrett

Discussion

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Overview

Hypothesis-generating in submassive PE; randomized trials needed before any practice change.

Structured PICO

Does inhaled nitric oxide improve dyspnoea and haemodynamics in patients with severe acute submassive pulmonary embolism?

P
Population
8 patients with CT-demonstrated, submassive pulmonary embolism (PE) and moderate to severe dyspnoea, recruited from the emergency department of an academic teaching hospital.
I
Intervention
Inhaled nitric oxide administered via a commercial device and custom-made non-rebreathing face mask, increased at 1 ppm/min to a maximum of 25 ppm, continued for 120 min, and then weaned at 1 ppm/min.
O
Outcome
Dyspnoea assessed with the Borg score, oxygenation by pulse oximetry, and haemodynamic status by shock index (HR/SBP) at 155 minutes.patient reported

A structured protocol for inhaled nitric oxide safely reduced dyspnoea and improved haemodynamics in a small pilot study of patients with severe submassive pulmonary embolism.

Cite This Study

Kline et al. (2013) studied this question.

synapsesocial.com/papers/6a802d2e9b5ec1a880470270https://doi.org/10.1136/emermed-2013-202426
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Inhaled Nitric Oxide in Acute Pulmonary Embolism: A Systematic Review2015 · 37 citations
  2. 2Inhaled nitric oxide has pulmonary vasodilator efficacy both in the immediate and prolonged phase of acute pulmonary embolism2020 · 23 citations
  3. 3Acute effects of inhaled nitric oxide on inspiratory neural drive, dyspnea and exercise endurance in symptomatic patients post-pulmonary embolism2026
  4. 4Is There a Place for Inhaled Nitric Oxide in the Therapy of Massive Pulmonary Embolism?2001 · 2 citations
  5. 5Inhaled Nitric Oxide for the Prevention of Impaired Arterial Oxygenation during Myocardial Revascularization with Extracorporeal Circulation2011 · 2 citations