PULMONARY-FUNCTION IN ADULT SURVIVORS OF SEVERE ACUTE LUNG INJURY TREATED WITH INHALED NITRIC-OXIDE

Background: Following an episode of acute respiratory distress syndrom e (ARDS), some degree of measurable pulmonary impairment may be antici pated. ARDS is thought to be the more severe form of acute lung injury (ALI) and a recently proposed addition to conventional therapy in ALI /ARDS is inhaled nitric oxide (INO). We carried out a non-randomised f ollow-up study with pulmonary function tests on survivors of severe AL I/ARDS treated with INO. Methods: Sixteen previously healthy pulmonary patients, survivors of severe ALI/ARDS, were evaluated with pulmonary function tests >8 months after the acute event. The tests included st atic and dynamic spirometry, diffusion capacity for carbon monoxide (D LCO) blood gas analysis and evaluation of a chest radiograph. Results: The most common abnormality seen was a low DLCO in 69% of the patient s. Abnormally low values were seen in forced vital capacity in 31%, in forced expiratory volume in 1 s in 13%, and in residual volume and to tal lung capacity in 6%. Blood gas data were within normal limits in 1 5/16 patients. All chest radiographs showed resolution of the intersti tial and alveolar changes present during the acute event. Conclusion: In this non-randomised follow-up study we conclude that a degree of me asurable pulmonary impairment after INO treatment in severe ALI/ARDS w as common, but did not differ markedly from other published studies on pulmonary function in similar patient material. No late unexpected ma jor abnormalities due to the inhaled nitric oxide treatment could be i dentified in these survivors.