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Exhaled Nitric Oxide in Patients with Ventilator Associated Pneumonia
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Hyun Jung Kwak, Sang Heon Kim, Tae Hyung Kim, Ho Joo Yoon, Dong Ho Shin, Sung Soo Park, Jang Won Sohn
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Korean J Crit Care Med. 2012;27(2):82-88.
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DOI: https://doi.org/10.4266/kjccm.2012.27.2.82
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- BACKGROUND
Fraction of exhaled nitric oxide (FENO) is known as a marker of inflammation in asthma, cystic fibrosis and exacerbation of COPD. However, its importance has not been established in patients using mechanical ventilation. We assessed whether FENO is elevated in patients with ventilator associated pneumonia (VAP), and physiologic or pathologic factors affecting levels of FENO in patients with mechanical ventilation. METHODS All patients (over 18-year-old) using mechanical ventilation were included, and among them, VAP patients were diagnosed on the basis of clinical pulmonary infection score (CPIS). We measured FENO in air collected during the end-expiratory pause via an off-line method. We compared the levels of FENO between patients with VAP and without, and assessed the relationship between FENO and other physiologic or pathologic characteristics; age, gender, PaO2, oxygenation index, CPIS. RESULTS A total of 43 patients (23 male, mean age 67.7 +/- 10.7) in an ICU were enrolled; 19 of them were VAP-patients (10 male, mean age 64.8 +/- 12.9). The level of FENO in the VAP-patients was substantially higher than in the non-VAP group (55.8 +/- 25.3 ppb Vs. 31.8 +/- 13.5 ppb, p < 0.001).
CPIS on day 1 and day 3, and duration of mechanical ventilation, were associated with the level of FENO, but oxygenation index, PaO2, PaO2/FiO2, and the mean PEEP were not. CONCLUSIONS FENO may be useful for the diagnosis of VAP, and is related to CPIS, as well as the duration of mechanical ventilation.
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Citations
Citations to this article as recorded by 
- Exhaled nitric oxide in intubated ICU patients on mechanical ventilation—a feasibility study
Andreas Kofoed, Mathias Hindborg, Jeppe Hjembæk-Brandt, Christian Dalby Sørensen, Mette Kolpen, Morten H Bestle Journal of Breath Research.2023; 17(4): 046014. CrossRef - Clinical Application of Exhaled Nitric Oxide Measurements in a Korean Population
Woo-Jung Song, Ji-Won Kwon, Eun-Jin Kim, Sang-Min Lee, Sae-Hoon Kim, So-Yeon Lee, Sang-Heon Kim, Heung-Woo Park, Yoon-Seok Chang, Woo Kyung Kim, Jung Yeon Shim, Ju-Hee Seo, Byoung-Ju Kim, Hyo Bin Kim, Dae Jin Song, Gwang Cheon Jang, An-Soo Jang, Jung-Won Allergy, Asthma & Immunology Research.2015; 7(1): 3. CrossRef - Exhaled breath analysis in the differentiation of pneumonia from acute pulmonary oedema
Silvie Prazakova, Nadine Elias, Paul S Thomas, Deborah H Yates Pulmonology and Respiratory Research.2015; 3(1): 3. CrossRef
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Acute Pulmonary Edema after Cardioversion for Torsade de Pointes:A Case Report
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Na Rae Ha, Duk Joo Lee, Tae Hyung Kim, Ho Joo Yoon, Dong Ho Shin, Jang Won Sohn, Sung Soo Park
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Korean J Crit Care Med. 2007;22(1):52-56.
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Abstract
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- Cardioversion used for the treatment of various cardiac arrhythmias is a safe and effective procedure with infrequent complication. The restoration of sinus rhythm is followed by a improvement in hemodynamics, but acute pulmonary edema has been reported as a rare complication following successful electrical reversion of various tachyarrhythmia to normal sinus rhythm. This report describes a 42-year-old woman with a history of schizophrenia who experienced pulmonary edema after cardioversion for torsade de pointes. She had taken chlorpromazine and haloperidol for schizophrenia. The antipsychotic drugs were suspected to induce QT interval prolongation and resultant torsade de pointes. Two hours after cardioversion, pulmonary edema developed on chest X-ray and chest computed tomography. She responded to conservative treatment including oxygen therapy and the pulmonary edema improved on the second hospital day. The mechanism of pulmonary edema after cardioversion is still uncertain and remains controversial.
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Pathophysiology and Pathogenesis of Acute Respiratory Distress Syndrome
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Sung Soo Park
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Korean J Crit Care Med. 1997;12(2):111-120.
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Abstract
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- No abstract available.
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