Inhaled nitric oxide in patients with pulmonary embolism

Abstract

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.