Exhaled nitric oxide in intubated ICU patients on mechanical ventilation-a feasibility study.

Autor:	Kofoed A; Department of Anesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark., Hindborg M; Department of Anesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark., Hjembæk-Brandt J; Department of Anesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark., Sørensen CD; Department of Anesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark., Kolpen M; Department of Clinical Microbiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.; Costerton Biofilm Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Bestle MH; Department of Anesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Jazyk:	angličtina
Zdroj:	Journal of breath research [J Breath Res] 2023 Sep 25; Vol. 17 (4). Date of Electronic Publication: 2023 Sep 25.
DOI:	10.1088/1752-7163/acf607
Abstrakt:	It can be a clinical challenge to distinguish inflammation from infection in critically ill patients. Therefore, valid and conclusive surrogate markers for infections are desired. Nitric oxide (NO) might be that marker since concentrations of exhaled NO have shown to change in the presence of various diseases. This observational, prospective, single-center feasibility study aimed to investigate if fractional exhaled NO (FeNO) can be measured in intubated patients with or without infection, pneumonia and septic shock in a standardized, reliable setting. 20 intubated patients in the intensive care unit (ICU) were included for analysis. FeNO mean values were measured in the endotracheal tube via the suction channel using a chemiluminescence based analyzer. We developed a pragmatic method to measure FeNO repeatedly and reliably in intubated patients using a chemiluminescence based analyzer. We found a median of 0.98 (0.59-1.44) FeNO mean (ppb) in exhaled breath from all 20 intubated patient. Intubated patient with suspected infection had a significantly lower median FeNO mean compared with the intubated patients without suspected infection. Similarly did patients with septic shock demonstrate a significantly lower median FeNO mean than without septic shock. We found no statistical difference in median FeNO mean for intubated patients with pneumonia. It was feasible to measure FeNO in intubated patients in the ICU. Our results indicate decreased levels of FeNO in infected intubated patients in the ICU. The study was not powered to provide firm conclusions, so larger trials are needed to confirm the results and to prove FeNO as a useful biomarker for distinguishment between infection and inflammation in the ICU. (© 2023 IOP Publishing Ltd.)
Databáze:	MEDLINE
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