Evidence map›Paper›PMID 42210269›Full record

ArticleRespiratory research2026

Relevant insights from personalized inhaled carbon monoxide dosing in a safety study in pneumonia and ARDS.

Rebecca M Baron, Antonio Arciniegas, Susan Sullivan, Michelle Courchaine, B Taylor Thompson, Alex Stenzler, Mary E Choi, Augustine M K Choi, Mark A Perrella, Tilo Winkler

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In one paragraph

Article in Respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Rebecca M Baron *Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital/Mass General Brigham and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. rbaron@bwh.harvard.edu.
Antonio Arciniegas *Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital/Mass General Brigham and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Susan SullivanDepartment of Respiratory Care, Brigham and Women's Hospital/Mass General Brigham, Boston, MA, USA.
Michelle CourchaineDepartment of Respiratory Care, Brigham and Women's Hospital/Mass General Brigham, Boston, MA, USA.
B Taylor ThompsonDivision of Pulmonary and Critical Care Medicine, Massachusetts General Hospital/Mass General Brigham and Harvard Medical School, Boston, MA, USA.
Alex Stenzler12TH Man Technologies, Inc, Long Beach, CA, USA.
Mary E ChoiDivision of Nephrology and Hypertension, Weill Cornell Medicine, New York, NY, USA.
Augustine M K ChoiDivision of Pulmonary and Critical Care Medicine, Weill Cornell Medicine, New York, NY, USA.
Mark A Perrella *Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital/Mass General Brigham and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Tilo Winkler *Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital/Mass General Brigham and Harvard Medical School, Boston, MA, USA.

Funding

Cellular Therapy for Sepsis and Lung InjuryR35GM161257 · NIGMS · BRIGHAM AND WOMEN'S HOSPITAL · PI Mark A PERRELLA · 2026 to 2026
$446k
NIGMS NIH HHS R35 GM161257NIH/NHLBI R61/R33 HL153011
6 · The paper itself

Abstract

backgroundLow-dose inhaled carbon monoxide (iCO) has demonstrated significant therapeutic potential in preclinical studies, and its safety has been established in human studies. However, the safety of delivering personalized iCO concentrations of 200 to 500 ppm in ventilated patients with pneumonia and ARDS, targeting 7% HbCO at 90 min of exposure, remains unknown.

methodsPersonalized iCO concentrations needed to reach a plasma HbCO of 7% at 90 min were determined using a Coburn-Forster-Kane (CFK) calculator, utilizing baseline and 20-minute (20-min) arterial HbCO measurements at an iCO test concentration of 200 ppm. The personalized iCO concentration was administered for the remainder of the 90 min with HbCO measurements performed at 60-, 75-, and 90-minutes.

resultsThere were no safety incidents observed during the study, and all exposed subjects were alive and well at 6-month follow-up. Surprisingly, we found significant deviations between measured and predicted HbCO levels at 90 min for individualized exposures with iCO of 220 to 425 ppm (p < 0.001), which were more discrepant at higher iCO doses. However, fitting the CFK model to the 20- to 90-minute HbCO measurements confirmed the validity of the CFK model and revealed significant deviations for baseline HbCO (p < 0.001), suggesting pulmonary vascular responses to iCO during the 20-min test exposure, confirmed by observed changes in DLCO.

conclusionsPulmonary vasodilation in response to iCO can affect early HbCO kinetics, which is relevant to refining protocols for reliable, personalized iCO administration that optimize pulmonary iCO concentrations, thereby increasing the benefits of therapeutic iCO administration in lung diseases.

Indexed as

Carbon MonoxidePneumoniaPrecision MedicineRespiratory Distress SyndromeAdministration, InhalationAdultAgedDose-Response Relationship, DrugFemaleHumansMaleMiddle AgedCarbon MonoxideAcute respiratory distress syndromeCoburn-Forster-Kane modelHuman studyInhalation therapyInhaled carbon monoxidePersonalized medicinePhase I trialPulmonary vasodilationTherapeutic gas deliveryVentilation-perfusion ratio

Identifiers

PMID42210269
PMCPMC13218005

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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.