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Combination of Inhaled Nitric Oxide Therapy and Inverse Ratio Ventilation in Patients with Sepsis‐Associated Acute Respiratory Distress Syndrome
Author(s) -
Okamoto Kazufumi,
Kukita Ichiro,
Hamaguchi Masamichi,
Kikuta Koichi,
Matsuda Kohji,
Motoyama Takeshi
Publication year - 2000
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1046/j.1525-1594.2000.06554-2.x
Subject(s) - ards , medicine , oxygenation , nitric oxide , hypoxemia , mechanical ventilation , anesthesia , ventilation (architecture) , sepsis , respiratory distress , acute respiratory distress , cardiology , lung , mechanical engineering , engineering
Inverse ratio ventilation (IRV) is a ventilatory technique that uses an inspiratory to expiratory ratio (I:E) greater than 1:1. We studied the effects of mechanical ventilation with an I:E of 1:3, 1:1, and 2:1 on arterial oxygenation in 10 patients with sepsis‐associated acute respiratory distress syndrome (ARDS). At each I:E, patients received 0 and 4 ppm of inhaled nitric oxide (INO) in random order for 30 min. Respiratory and cardiovascular parameters were measured. Of the 10 patients studied, 7 responded to IRV and 3 did not. An increase in the I:E and the addition of INO significantly improved arterial oxygenation in the responders (p < 0.0001 and p < 0.006, respectively). The combination of an increase in the I:E and INO had an additive effect on arterial oxygenation. The combined use of IRV and INO is a more effective method of avoiding hypoxemia than either INO or IRV alone.