The effects of inhaled @entity842 (NO) in two young adults who developed severe acute @entity649 are presented. Modest improvements in gas exchange and @entity551 occurred after the initiation of treatment with inhaled NO. However, both @entity1 became "dependent" on the inhaled NO for stabilization of their cardiopulmonary function. Repeated attempts to discontinue the inhaled NO resulted in life-threatening deterioration in gas exchange and @entity1344 . Prolonged family discussions were held regarding the withdrawal of inhaled NO and other life-sustaining therapies, when the irreversible nature of the @entity1 ' @entity358 became apparent. However, both families were strong in their desire to continue all therapies--due in large part to the single organ nature of the disease process. Both @entity1 died while receiving inhaled NO and escalating doses of sedative and analgesics. Based on this experience, it is recommended that clearly defined goals or endpoints for the discontinuation of inhaled NO should be established before its initial administration. If these goals are not achieved, then the therapy should be considered a failure and withdrawn. A similar strategy should be applied to all life-sustaining therapies in the intensive care unit setting (e.g., mechanical ventilation, vasopressors, dialysis). This requires that critical care clinicians effectively communicate the difference between aggressive supportive care and definitive treatment of the underlying disease process to @entity1 or their families, or both. Furthermore, until the results of ongoing clinical trials of inhaled NO become available, it is recommended that its administration be restricted to medical centers examining its use in clinical trials.

Inhaled XXXX for severe acute @entity649 : a blessing or a curse?

@entity1 :: ('9606', 'Species') :: ['patients'] @entity649 :: ('MESH:D012128', 'Disease') :: ['respiratory distress syndrome'] @entity358 :: ('MESH:D008171', 'Disease') :: ['lung disease'] @entity842 :: ('MESH:D009569', 'Chemical') :: ['nitric oxide'] @entity1344 :: ('MESH:D043171', 'Disease') :: ['hemodynamic instability'] @entity551 :: ('MESH:D007022', 'Disease') :: ['reductions in pulmonary artery pressures']
@entity842 :: (MESH:D009569,Chemical) :: ['nitric oxide']
