Work

Reply to Eleuteri et al. : High-Dose Inhaled Nitric Oxide in Acute Hypoxemic Respiratory Failure: Need for Patient Phenotyping?

Year: 2023

Type: letter

Abstract: dead space fraction.Accordingly, the ventilatory ratio, a proxy of dead space, performs at least as well as the Pa O 2 /FI O 2 ratio in predicting mortality among patients with COVID-19 with ARDS (8).Di Fenza and colleagues report a subgroup analysis that stratified patients according to ARDS severity, with the greatest benefit appearing in patients with the most severe hypoxemia (Pa O 2 /FI O 2 ratio ,100).Because part of the positive effects of NO administration is expected to be related to its vasoactive properties, it would be interesting to assess if NO could provide a significant clinical advantage in patients with a high versus a low ventilatory ratio (i.e., high vs. low alveolar dead space).This post hoc analysis, combined with the results stratified according to ARDS severity, may help clinicians identify patients with the highest likelihood of clinical benefit from NO as administered in this important randomized trial.

Source: American Journal of Respiratory and Critical Care Medicine

DOI: 10.1164/rccm.202311-2112le

Authors: Naman S. Shetty, Mokshad Gaonkar, Valentina Giammatteo, Pankaj Arora, Lorenzo Berra

Institutions: University of Alabama at Birmingham, Harvard University, Birmingham VA Medical Center, Massachusetts General Hospital

Language: English

Topic: Respiratory Support and Mechanisms

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Funders: Massachusetts General Hospital, National Institutes of Health, National Heart, Lung, and Blood Institute