tailieunhanh - Báo cáo y học: "Inhaled nitric oxide in acute respiratory distress syndrome with and without septic shock requiring norepinephrine administration: a dose–response study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Inhaled nitric oxide in acute respiratory distress syndrome with and without septic shock requiring norepinephrine administration: a dose–response study. | Available online http content 1 1 25 Research Inhaled nitric oxide in acute respiratory distress syndrome with and without septic shock requiring norepinephrine administration a dose-response study Eric Mourgeon1 Louis Puybasset1 Jean-Dominique Law-Koune1 Qin Lu1 Lamine Abdennour1 Lluis Gallart1 Patrick Malassine1 GS Umamaheswara Rao1 Philippe Cluzel3 Abdelhai Bennani2 Pierre Coriat1 and Jean-Jacques Rouby1 1Unité de Réanimation Chirurgicale Département d Anesthésie Hôpital de la Pitié-Salpétrière 83 Boulevard de 1 Hôpital 75013 Paris France. 2Laboratoire de Biologie Hôpital de la Pitié-Salpétrière 83 Boulevard de I Hôpital 75013 Paris France. 3Département de Radiologie Hôpital de la Pitié-Salpétrière 83 Boulevard de I Hôpital 75013 Paris France. Received 18 December 1996 Revisions requested 26 February 1997 Revisions received 19 April 1997 Accepted 9 June 1997 Published 13 August 1997 1997 Current Science Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Crit Care 1997 1 25 Abstract Background The aim of this prospective study was to assess whether the presence of septic shock could influence the dose response to inhaled nitric oxide NO in NO-responding patients with adult respiratory distress syndrome ARDS . Results Eight patients with ARDS and without septic shock PaO2 95 16 mmHg PEEP 0 FiO2 and eight patients with ARDS and septic shock PaO2 88 11 mmHg pEeP 0 FiO2 receiving exclusively norepinephrine were studied. All responded to 15 ppm inhaled NO with an increase in PaO2 of at least 40 mmHg at FiO2 and PEEP 10 cmH2O. Inspiratory intratracheal NO concentrations were recorded continuously using a fast response time chemiluminescence apparatus. Seven inspiratory NO concentrations were randomly administered 15 45 and 150 ppm. In both groups NO induced a dose-dependent decrease in mean pulmonary artery pressure MPAP pulmonary vascular resistance index PVRI and venous admixture Qva Qt and a dosedependent increase in PaO2 FiO2 P