Evidence map›Paper›PMID 35623183›Full record

Trial reportThe American journal of emergency medicine2022

Safety and practicality of high dose inhaled nitric oxide in emergency department COVID-19 patients.

Brian Strickland, Lorenzo Albala, El Centro Coffey, Ryan W Carroll, Warren M Zapol, Fumito Ichinose, Lorenzo Berra, N Stuart Harris

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The American journal of emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06950294 (High Dose Inhaled Nitric Oxide Therapy in Critically Ill Patients With Pneumonia), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
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.

NCT06950294 early_phase1recruitingnot on this mapstarted 2026, after this paper: background citation

High Dose Inhaled Nitric Oxide Therapy in Critically Ill Patients With Pneumonia: a Pilot, Double-blinded, Randomized, Controlled Trial

TypeinterventionalSponsorMassachusetts General HospitalRan2026 to 2026Enrolled34ConditionsCritical Illness, PneumoniaArmsHigh dose inhaled nitric oxide, Sham treatment, standard therapy
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
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.

Brian StricklandDivision of Wilderness Medicine, Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America. Electronic address: brian.strickland@cuanschutz.edu.
Lorenzo AlbalaDivision of Wilderness Medicine, Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America.
El Centro CoffeyDivision of Wilderness Medicine, Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America.
Ryan W CarrollDepartment of Pediatrics, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America.
Warren M ZapolAnesthesia Center for Critical Care Research (ACCCR), Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America.
Fumito IchinoseRespiratory Care Service, Patient Care Services, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America.
Lorenzo BerraRespiratory Care Service, Patient Care Services, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America; Surgical Intensive Care Unit, Department of Anesthesia, Critical Care and Pain Medicine (DACCPM), Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America.
N Stuart HarrisDivision of Wilderness Medicine, Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America.
Massachusetts General Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInhaled nitric oxide (iNO) is a selective pulmonary vasodilator and mild bronchodilator that has been shown to improve systemic oxygenation, but has rarely been administered in the Emergency Department (ED). In addition to its favorable pulmonary vascular effects, in-vitro studies report that NO donors can inhibit replication of viruses, including SARS Coronavirus 2 (SARS-CoV-2). This study evaluated the administration of high-dose iNO by mask in spontaneously breathing emergency department (ED) patients with respiratory symptoms attributed to Coronavirus disease 2019 (COVID-19).

methodsWe designed a randomized clinical trial to determine whether 30 min of high dose iNO (250 ppm) could be safely and practically administered by emergency physicians in the ED to spontaneously-breathing patients with respiratory symptoms attributed to COVID-19. Our secondary goal was to learn if iNO could prevent the progression of mild COVID-19 to a more severe state.

findingsWe enrolled 47 ED patients with acute respiratory symptoms most likely due to COVID-19: 25 of 47 (53%) were randomized to the iNO treatment group; 22 of 47 (46%) to the control group (supportive care only). All patients tolerated the administration of high-dose iNO in the ED without significant complications or symptoms. Five patients receiving iNO (16%) experienced asymptomatic methemoglobinemia (MetHb) > 5%. Thirty-four of 47 (72%) subjects tested positive for SARS-CoV-2: 19 of 34 were randomized to the iNO treatment group and 15 of 34 subjects to the control group. Seven of 19 (38%) iNO patients returned to the ED, while 4 of 15 (27%) control patients did. One patient in each study arm was hospitalized: 5% in iNO treatment and 7% in controls. One patient was intubated in the iNO group. No patients in either group died. The differences between these groups were not significant.

conclusionA single dose of iNO at 250 ppm was practical and not associated with any significant adverse effects when administered in the ED by emergency physicians. Local disease control led to early study closure and prevented complete testing of COVID-19 safety and treatment outcomes measures.

Indexed as

COVID-19Respiratory InsufficiencyAdministration, InhalationEmergency Service, HospitalHumansNitric OxideSARS-CoV-2Nitric OxideCOVID-19Emergency departmentNitric oxide

Identifiers

PMID35623183
PMCPMC9066706
OpenAlexW4225416992

What OpenQuestion holds

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Registered trials

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.