Gac Med Mex
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Review Case Reports
[Inhaled nitric oxide: one modality in the treatment of ARDS].
We describe a patient with acute respiratory distress syndrome (ARDS), refractory to treatment with conventional mechanical ventilation. The hemodynamic parameters showed severe pulmonary hypertension with increased intrapulmonary shunt. Inhaled nitric oxide was administered and we observed a diminishing in pulmonary hypertension and intrapulmonary shunt with an important increase of oxygen exchange. We reviewed the literature and make a suggestion concerning use of inhaled nitric oxide in patients with ARDS.
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Subarachnoid hemorrhage constitutes approximately 10% of cases of cerebrovascular disease and its incidence ranges between 11 and 28 cases/100,000/year. More than 80% of cases are secondary to rupture of cerebral aneurysm; however, in 5 to 16% of patients with subarachnoid hemorrhage it is not possible to find a cause (subarachnoid hemorrhage with negative angiography). This group of patients represents a dilemma for the correct diagnosis, treatment and prognosis; there is no consensus on the criteria to repeat the angiography after the first negative study. ⋯ Our observations suggest that the overall prognosis for these patients is very good (86%). The risk of another hemorrhage after discharge from the hospital is small. Our results are compared with those in other published series.