Pneumonia triggered by COVID-19 is especially threatening to pregnant girls since it might shortly progress to oxygen insufficiency within the blood and bodily tissues, a situation often called hypoxemia, requiring hospitalization and cardiopulmonary assist. “Compared to non-pregnant female patients with COVID-19, pregnant women are three times more likely to need intensive care unit admission, mechanical ventilation, or advanced life support, and four times more likely to die,” notes Carlo Valsecchi, MD, lead creator within the Department of Anesthesia, Critical Care and Pain Medicine, MGH. “They also face a greater risk of obstetric complications such as preeclampsia, preterm delivery, and stillbirth.”
Nitric oxide is a therapeutic fuel that was initially permitted by the US Food and Drug Administration in 1999 for inhalation therapy of intubated and mechanically ventilated newborns with hypoxic respiratory failure. With MGH driving many early research, iNO in excessive concentrations was additionally proven to be efficient as an antimicrobial in lowering viral replication of SARS-CoV-1 and, extra lately, SARS Co-V-2, the virus that causes COVID-19. During the primary wave of COVID-19, MGH handled six non-intubated pregnant sufferers with iNO at excessive doses of as much as 200 elements per million (ppm). Findings of a extra favorable end result with iNO led MGH clinicians to supply this therapy to different pregnant sufferers, and to design the present examine to find out the protection and efficacy of iNO200 for COVID-19 pneumonia in being pregnant.
To that finish, a collaborative community of 4 medical facilities within the Boston space was shaped. In addition to MGH, it included Tufts Medical Center, Beth Israel Deaconess Medical Center, and Boston Medical Center. Researchers and clinicians from a number of departments — together with essential care medication, respiratory care, and maternal fetal medication — studied 71 pregnant sufferers with extreme COVID-19 pneumonia admitted to those hospitals, 20 of whom acquired iNO200 twice each day. The examine discovered that iNO remedy at this dosage, when in comparison with commonplace of care alone, resulted in reductions within the want for supplemental oxygen and in hospital and ICU lengths of keep. No antagonistic occasions associated to the intervention had been reported in both moms or their infants.
“Being able to wean patients from respiratory support quicker could have other profound implications, including reducing stress on women and their families, lowering the risk of hospital-acquired infections, and relieving the burden on the health care system,” notes Berra. “Above all, our study supports the safety of high dose nitric oxide in the pregnant population, and we hope more physicians will consider incorporating it into carefully monitored treatment regimens.”