Can High Dose Nitric Oxide Improve Respiratory Function in Pregnant Women with Severe COVID-19?
There is limited data on how best to manage respiratory failure in pregnant women with COVID-19
Safaee Fakhr et al. sought to determine if administering high concentrations of nitric oxide could improve the clinical course of pregnant women with respiratory failure
Case series (April to June 2020)
6 pregnant patients admitted with severe or critical COVID-19
Patients received high-dose (160–200 ppm) nitric oxide by mask twice daily
Treatment sessions lasted 30 minutes to 1 hour
For those patients requiring mechanical ventilation, the high dose regimen was stopped and restarted after extubation | During intubation, the patients received continuous low dose nitric oxide through the ventilator
Total of 39 treatments
Cardiopulmonary function improved with administration of nitric oxide
Systemic oxygenation: Improved following each administration session in hypoxemic patients
Tachypnea: Reduced among all patients each session
3 deliveries while in hospital
28-day follow-up: All mothers and infants in good condition at home
3 remaining patients:
Discharged home and still pregnant at time of publication
There were no adverse events documented
While acknowledging the small cohort size, the authors also conclude that
Nitric oxide at 160–200 ppm is easy to use, appears to be well tolerated, and might be of benefit in pregnant patients with COVID-19 with hypoxic respiratory failure
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