Inhaled nitric oxide in patients with pulmonary embolism
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Objective: To describe the use of inhaled nitric oxide (NO) in four patients with severe pulmonary embolism. Setting: The intensive care unit (ICU) of a university teaching hospital. Patients: Four patients with severe pulmonary embolism on the basis of clinical, haemodynamic or blood-gas parameters received NO by inhalation either during spontaneous respiration (two cases) or while mechanically ventilated (two cases). Interventions: Conventional management of pulmonary embolism in addition to the use of inhaled NO. Measurements and results: Description of clinical course, haemodynamic and gas-exchange data. Dose-response data are also described for three patients. Conclusions: We reported four cases of pulmonary embolism where the administration of inhaled NO resulted in an improvement in pulmonary haemodynamic and gas-exchange parameters. Two patients were weaned from NO and survived until discharged from the ICU. Inhaled NO might be a useful adjunct in pulmonary embolism to improve stability of the patient prior to thrombolysis or surgery.
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