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July 21, 2004

Inhaled Nitric Oxide in Acute Lung Injury

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;292(3):327. doi:10.1001/jama.292.3.327-a

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.