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Because nitric oxide is a selective pulmonary vasodilator with anti-inflammatory effects, it has been used to treat acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Nonetheless, a 2003 systematic review of trials testing this practice provided little support for the use of nitric oxide. This updated review provides even less support.
Reviewers found 12 trials in which 1237 patients were randomly assigned to receive either nitric oxide or control therapy for ALI/ARDS. Although treatment regimens varied, the studies were of generally good scientific quality. Hospital mortality risk was not significantly affected by treatment (risk ratio, 1.10 for nitric oxide). The same was true for duration of ventilation (17% increase for ni…