Feasibility of non-invasive nitric oxide gas inhalation to prevent endotracheal intubation in patients with acute hypoxemic respiratory failure: A single-centre experience
- Resource Type
- Authors
- Kiran Shekar; Matthew Siuba; Leanne Parsons; George Cornmell; Mahesh Ramanan; Maneesha Tol; Sneha Varkey
- Source
- Nitric Oxide. 116:35-37
- Subject
- Adult
Male
Cancer Research
Physiology
medicine.medical_treatment
Clinical Biochemistry
Nitric Oxide
Biochemistry
Hypoxemia
Nitric oxide
chemistry.chemical_compound
Oxygen therapy
Administration, Inhalation
Intubation, Intratracheal
medicine
Respiratory muscle
Cannula
Humans
Aged
Retrospective Studies
Mechanical ventilation
business.industry
Oxygen Inhalation Therapy
Oxygenation
Middle Aged
Prognosis
chemistry
Anesthesia
Female
medicine.symptom
Respiratory Insufficiency
Airway
business
Hypercapnia
- Language
- ISSN
- 1089-8603
Background Acute hypoxemic respiratory failure (ARF) is characterized by both lower arterial oxygen and carbon dioxide tensions in the blood. First line treatment for ARF includes oxygen therapy – intially administered non invasively using nasal prongs, high flow nasal cannulae (HFNC) or masks. Invasive mechanical ventilation (IMV) is usually reserved for patients who are unable to maintain their airway, those with worsening hypoxemia, or those who develop respiratory muscle fatigue and consequent hypercapnia. Inhaled nitric oxide (iNO) gas is known to improve oxygenation in patients with ARF by manipulating ventilation-perfusion matching. Addition of iNO may potentially alleviate the need for IMV in selected patients. Case summary In this article we report our preliminary experience of using HFNC to deliver oxygen and nitric oxide gas in patients with hypoxemic ARF as a strategy to potentially avoid IMV in selected patients. Conclusion This article demonstrates the feasibility of this technique based on our experience of patients with hypoxemic ARF and generates hypothesis for future studies.