Evidence map›Paper›PMID 35369798›Full record

ArticleJournal of intensive care medicine2022

Compassionate use of Pulmonary Vasodilators in Acute Severe Hypoxic Respiratory Failure due to COVID-19.

Lewis Matthews, Laurence Baker, Matteo Ferrari, Weronika Sanchez, John Pappachan, Mike Pw Grocott, Ahilanandan Dushianthan, REACT COVID-19 investigators

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Inhaled Nitric Oxide for Clinical Management of COVID-19: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022
    Pooled it
  2. Pooled it
  3. Review
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Lewis MatthewsGeneral Intensive Care Unit, 7425University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD.ORCID https://orcid.org/0000-0001-5967-8615
Laurence BakerGeneral Intensive Care Unit, 7425University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD.
Matteo FerrariGeneral Intensive Care Unit, 7425University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD.
Weronika SanchezGeneral Intensive Care Unit, 7425University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD.
John PappachanNIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southamptom NHS Foundation Trust / University of Southampton, Tremona Road, Southampton, SO16 6YD.
Mike Pw GrocottGeneral Intensive Care Unit, 7425University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD.
Ahilanandan DushianthanGeneral Intensive Care Unit, 7425University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD.
REACT COVID-19 investigators
University Hospital Southampton NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere have been over 200 million cases and 4.4 million deaths from COVID-19 worldwide. Despite the lack of robust evidence one potential treatment for COVID-19 associated severe hypoxaemia is inhaled pulmonary vasodilator (IPVD) therapy, using either nitric oxide (iNO) or prostaglandins. We describe the implementation of, and outcomes from, a protocol using IPVDs in a cohort of patients with severe COVID-19 associated respiratory failure receiving maximal conventional support.

methodsProspectively collected data from adult patients with SARS-CoV-2 admitted to the intensive care unit (ICU) at a large teaching hospital were analysed for the period 14

resultsFifty-nine patients received IPVD therapy during the study period. The median PF ratio before IPVD therapy was commenced was 11.33kPa (9.93-12.91). Patients receiving an IPVD had a lower PF ratio (14.37 vs. 16.37kPa, p = 0.002) and higher APACHE-II score (17 vs. 13, p = 0.028) at ICU admission. At 72 hours after initiating an IPVD the median improvement in PF ratio was 33.9% (-4.3-84.1). At 72 hours changes in PF ratio (70.8 vs. -4.1%, p < 0.001) and reduction in A-a gradient (44.7 vs. 14.8%, p < 0.001) differed significantly between survivors (n = 33) and non-survivors (n = 26).

conclusionsThe response to IPVDs in patients with COVID-19 associated acute hypoxic respiratory failure differed significantly between survivors and non-survivors. Both iNO and prostaglandins may offer therapeutic options for patients with severe refractory hypoxaemia due to COVID-19. The use of inhaled prostaglandins, and iNO where feasible, should be studied in adequately powered prospective randomised trials.

Indexed as

COVID-19COVID-19 Drug TreatmentRespiratory Distress SyndromeRespiratory InsufficiencyAdministration, InhalationAdultCompassionate Use TrialsHumansHypoxiaNitric OxideProspective StudiesProstaglandinsSARS-CoV-2Vasodilator AgentsNitric OxideProstaglandinsVasodilator AgentsARDSCOVID-19Hypoxic respiratory failureIloprostIntensive careNitric oxidePulmonary vasodilators

Identifiers

PMID35369798
PMCPMC9353318
OpenAlexW4225351756

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.