The selective pulmonary vasodilatory effect of inhaled DETA/NO, a novel nitric oxide donor, in ARDS-a pilot human trial.

OBJECTIVES

To examine the effects of inhaled NONOates in patients with acute respiratory distress syndrome (ARDS).

DESIGN

Case-series, phase I clinical trial.

SETTING

A multidisciplinary intensive care unit in a tertiary teaching hospital.

PATIENTS

Five consecutive patients with ARDS (men; age range, 47-76 years).

MEASUREMENTS

DETA/NO (150 micromol) was aerosolized into the lungs of patients on mechanical ventilation via the endotracheal tube over 20 minutes. Hemodynamic parameters were measured and blood samples were taken before, during, and after inhalation.

RESULTS

Compared to baseline values, pulmonary vascular resistance decreased until the end of the study period (180 minutes) while intrapulmonary shunting decreased significantly up to 45 min after DETA/NO aerosol administration. Inhaled DETA/NO had no effect on the systemic circulation (systemic blood pressure or cardiac output).

CONCLUSIONS

Inhaled DETA/NO is a selective pulmonary vasodilator in patients with ARDS. However, a larger number of patients is required to confirm the findings of this pilot study.