tetano
Editor, Senior Moderator
J Crit Care Med (Targu Mures)
. 2021 Nov 17;8(1):33-40.
doi: 10.2478/jccm-2021-0037. eCollection 2022 Jan.
The Use of Inhaled Epoprostenol for Acute Respiratory Distress Syndrome Secondary Due To COVID-19: a Case Series
Komal Imtiaz[SUP] 1 [/SUP], Wade Jodeh[SUP] 2 [/SUP], Dave Sudekum[SUP] 2 [/SUP], Bruno DiGiovine[SUP] 2 [/SUP], Jason Hecht[SUP] 2 [/SUP]
Affiliations
Abstract
Introduction: Inhaled epoprostenol (iEpo) is a pulmonary vasodilator used to treat refractory respiratory failure, including that caused by Coronavirus 2019 (COVID-19) pneumonia.
Aim of study: To describe the experience at three teaching hospitals using iEpo for severe respiratory failure due to COVID-19 and evaluate its efficacy in improving oxygenation.
Methods: Fifteen patients were included who received iEpo, had confirmed COVID-19 and had an arterial blood gas measurement in the 12 hours before and 24 hours after iEpo initiation.
Results: Eleven patients received prone ventilation before iEpo (73.3%), and six (40%) were paralyzed. The partial pressure of arterial oxygen to fraction of inspired oxygen (P/F ratio) improved from 95.7 mmHg to 118.9 mmHg (p=0.279) following iEpo initiation. In the nine patients with severe ARDS, the mean P/F ratio improved from 66.1 mmHg to 95.7 mmHg (p=0.317). Ultimately, four patients (26.7%) were extubated after an average of 9.9 days post-initiation.
Conclusions: The findings demonstrated a trend towards improvement in oxygenation in critically ill COVID-19 patients. Although limited by the small sample size, the results of this case series portend further investigation into the role of iEpo for severe respiratory failure associated with COVID-19.
Keywords: acute respiratory distress syndrome; coronavirus; epoprostenol; severe acute respiratory syndrome.
. 2021 Nov 17;8(1):33-40.
doi: 10.2478/jccm-2021-0037. eCollection 2022 Jan.
The Use of Inhaled Epoprostenol for Acute Respiratory Distress Syndrome Secondary Due To COVID-19: a Case Series
Komal Imtiaz[SUP] 1 [/SUP], Wade Jodeh[SUP] 2 [/SUP], Dave Sudekum[SUP] 2 [/SUP], Bruno DiGiovine[SUP] 2 [/SUP], Jason Hecht[SUP] 2 [/SUP]
Affiliations
- PMID: 35274053
- PMCID: PMC8852286
- DOI: 10.2478/jccm-2021-0037
Abstract
Introduction: Inhaled epoprostenol (iEpo) is a pulmonary vasodilator used to treat refractory respiratory failure, including that caused by Coronavirus 2019 (COVID-19) pneumonia.
Aim of study: To describe the experience at three teaching hospitals using iEpo for severe respiratory failure due to COVID-19 and evaluate its efficacy in improving oxygenation.
Methods: Fifteen patients were included who received iEpo, had confirmed COVID-19 and had an arterial blood gas measurement in the 12 hours before and 24 hours after iEpo initiation.
Results: Eleven patients received prone ventilation before iEpo (73.3%), and six (40%) were paralyzed. The partial pressure of arterial oxygen to fraction of inspired oxygen (P/F ratio) improved from 95.7 mmHg to 118.9 mmHg (p=0.279) following iEpo initiation. In the nine patients with severe ARDS, the mean P/F ratio improved from 66.1 mmHg to 95.7 mmHg (p=0.317). Ultimately, four patients (26.7%) were extubated after an average of 9.9 days post-initiation.
Conclusions: The findings demonstrated a trend towards improvement in oxygenation in critically ill COVID-19 patients. Although limited by the small sample size, the results of this case series portend further investigation into the role of iEpo for severe respiratory failure associated with COVID-19.
Keywords: acute respiratory distress syndrome; coronavirus; epoprostenol; severe acute respiratory syndrome.