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To the Editor: Dr Taylor and colleagues¹ reported that low-dose inhaled nitric oxide did not decrease the number of days in the intensive care unit or overall mortality among adult patients with acute lung injury. We are uncertain of the justification for this trial. A previous publication by this group² reported that inhaled nitric oxide induced significant but transient improvements of PaO₂ in patients with acute respiratory distress syndrome (ARDS). Their current study was performed in patients with less severe degrees of hypoxemia, who would be expected to benefit even less than those with ARDS. We believe that the majority of such patients can be successfully and safely treated with standard clinical management.

In any event, none of the patients in the study by Taylor et al¹ were treated with extracorporeal membrane oxygenation (ECMO), and consequently, their study could not confirm prior studies that found that inhaled nitric oxide may . . . [Full Text of this Article]

Udo Kaisers, MD
udo.kaisers@charite.de

Maria Deja, MD; Willehad Boemke, MD; Thilo Busch, PhD
Charité, Campus Virchow-Klinikum
University Medical Center
Berlin, Germany

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