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Nitric Oxide May Harm Patients with Acute Lung Injury

While it improves oxygenation in short-term, nitric oxide seems to inflict renal damage without reducing mortality rates

FRIDAY, March 23 (HealthDay News) -- Nitric oxide offers adults and children with acute lung injury or acute respiratory distress syndrome some modest, temporary benefits in terms of oxygenation, but it does not reduce death rates and may cause kidney damage, researchers report in a study published online March 23 in BMJ.

Neill K.J. Adhikari, M.D., of the University of Toronto in Canada, and colleagues analyzed 12 placebo-controlled studies of nitric oxide in 1,237 patients with acute respiratory distress syndrome or acute lung injury.

Nitric oxide had no major impact on ventilator-free days, ventilation duration or hospital deaths. On the first day, patients treated with nitric oxide experienced a 14 percent drop in the oxygenation index and a 13 percent increase in the ratio of partial pressure of oxygen to fraction of inspired oxygen. Although oxygenation benefits lasted until day four, the risk of renal damage was 1.5 times greater than in those treated with placebo.

"Nitric oxide is associated with limited improvement in oxygenation in patients with acute lung injury or acute respiratory distress syndrome but confers no mortality benefit and may cause harm," the authors write. "We do not recommend its routine use in these severely ill patients."

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