Inhaled Nitric Oxide Improves Oxygenation in Pregnant Patients With COVID-19 Pneumonia
In This Article
- Pneumonia caused by COVID-19 is particularly threatening to pregnant patients, as it can quickly progress to oxygen insufficiency in the blood and bodily tissues
- Led by Massachusetts General Hospital, a team of four Boston medical centers investigated the use of high-dose inhaled nitric oxide gas (iNO) as a potential respiratory therapy
- The team studied 71 pregnant patients with severe COVID-19 pneumonia, 20 of whom were treated with iNO at high doses of up to 200 parts per million (iNO200)
- Patients treated with iNO200 had reduced need for supplemental oxygen and experienced shorter hospital and ICU lengths of stay, compared to standard of care alone
Pregnant patients are particularly vulnerable to pneumonia triggered by COVID-19. Hospitalization and cardiopulmonary support are often required as pneumonia can quickly progress to hypoxemia, with insufficient oxygen in the blood and bodily tissues.
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A research team led by Massachusetts General Hospital investigated the use of high-dose inhaled nitric oxide gas (iNO) as a respiratory therapy for pregnant women hospitalized with COVID-19 pneumonia. This follows several early studies led by Mass General that demonstrated the effectiveness of high concentrations of iNO as an antimicrobial for COVID-19, one of which involved the successful treatment of six non-intubated pregnant patients with iNO at high doses of up to 200 parts per million (iNO200).
In this study, the team found that iNO safely and effectively decreased the respiratory rate of hospitalized pregnant women with low oxygenation blood levels and reduced hospital and ICU lengths of stay, compared to standard of care alone.
Senior author Lorenzo Berra, MD, medical director for Respiratory Care and anesthesiologist in the Department of Anesthesia, Critical Care and Pain Medicine at Mass General, lead author Carlo Valsecchi, MD, research fellow in the department, and colleagues report the findings in Obstetrics & Gynecology.
Methods
The team, comprised of four Boston-based medical centers, studied 71 pregnant patients hospitalized with severe COVID-19 pneumonia. 51 patients received standard of care alone, and 20 patients received iNO200 twice a day.
The patients treated with iNO200 experienced a reduced need for supplemental oxygen and had shorter lengths of stay in the hospital and ICU, compared to patients who received standard of care alone. No adverse events related to the intervention were reported in either the mothers or their babies.
Applying the Findings
These findings indicate that iNO is a safe and effective respiratory therapy for pregnant patients hospitalized with severe COVID-19 pneumonia. The shorter length of time for respiratory support and hospital length of stay has other positive implications, including reduced risk of infection, stress on patients and their families, and financial burden on the healthcare system.
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