• S Aardal and H Flaatten.
• Anestesi- og Intensivavdeling, Haukeland Sykehus, Bergen.
• Tidsskr. Nor. Laegeforen. 1996 Apr 20; 116 (10): 1210-3.

AbstractAdult respiratory distress syndrome (ARDS) still has a high rate of mortality. It is usually necessary to treat these patients with a respirator using a high inspiratory fraction of oxygen. The condition is often associated with pulmonary hypertension and increased pulmonary vascular resistance. Nitric oxide (NO) has been shown to be a potent endogenous vasodilator. It is a gas and can thus be delivered to the lungs of intubated patients by means of a respirator. Because of its very short halflife, the effect of inhaled nitric oxide is limited to the pulmonary vasculature and it has no systemic effects. The local vasodilatation caused by nitric oxide leads to improved oxygenation, primarily because of reduced intrapulmonary shunting of blood. From April 1993 to July 1995 we treated 14 patients with severe ARDS with inhaled nitric oxide. All patients were critically ill, with a mean APACHE II score of 24.5. Oxygenation was increased in all patients after treatment with nitric oxide, but in spite of this eight patients (56%) died. There were no significant differences between survivors and non-survivors as regards age or severity of the disease.

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