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Inhaled Nitric Oxide in Severe Obesity

The Effect of Inhaled Nitric Oxide on Intrapulmonary Shunt in Acutely Hypoxemic Patients With Severe Obesity

Who can join

As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.

Age
18 Years and older
Sex
All sexes
Healthy volunteers
Not accepted
Compensation
Not stated

Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.

What to expect

No one can promise a trial will help you personally — that is what the research is trying to find out.

What participation involves

Not stated in the study description — ask the study team about visits and procedures.

Compensation
Not stated
  • Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
  • Participants are monitored closely by the research team throughout the study.
  • Some participants may receive access to an investigational treatment, which is still being studied.
  • Your participation helps researchers learn whether this approach could help future patients.

About this study

The goal of this clinical trial is to learn about the effects of inhaled nitric oxide on oxygenation and lung perfusion in participants with severe obesity who have acute hypoxemic respiratory failure and are on mechanical ventilation The main questions it aims to answer are: 1. In acute hypoxemic respiratory failure, what are the effects of inhaled nitric oxide on oxygenation in participants with severe obesity compared to participants with normal body weight. 2. In acute hypoxemic respiratory failure, what are the effects of inhaled nitric oxide on lung perfusion and heart function in participants with severe obesity compared to participants with normal body weight. 3. In acute hypoxemic respiratory failure, does severe obesity impact nitric oxide signaling pathways? Participants with acute hypoxemic respiratory failure will be exposed to inhaled nitric oxide (20 ppm) while being clinically monitored.

Compensation is read from the study's own description and may be missing — always confirm with the study team.

Eligibility

Official eligibility criteria

For participants with acute hypoxemic respiratory failure Inclusion Criteria: * Acute hypoxemic respiratory failure, defined as persistent hypoxemia (PaO2/FiO2 ≤ 300 mmHg or SpO2/FiO2 ≤ 315) and on invasive mechanical ventilation for \< 72 hours * Presence of an arterial and central venous catheter (for blood gas measurement) * Admitted to a participating MGH ICU Exclusion Criteria: * Age \< 18 years * Pregnancy or known active breastfeeding * Prisoner or Incarceration * Inability or unwillingness of subject or legal surrogate/representative to give written informed consent * Use of inhaled or oral pulmonary vasodilatory therapy within the 24 hours preceding study enrollment * Contraindication to inhaled NO * Baseline Methemoglobin ≥ 3% * Known left ventricle ejection fraction \< 20% * Known history of G6PD deficiency or cytochrome issues * Prior adverse reaction to inhaled nitric oxide * Presence of pneumothorax or acute pulmonary embolism * Chronic hypoxemia requiring home supplemental non-invasive oxygen (nasal cannula or positive pressure ventilation) or home mechanical ventilation * Chronic pulmonary vascular disease on home chemical vasodilator support (e.g., sildenafil) * History of lung resection or transplant * Hemodynamic instability at the time of potential study enrollment defined as: * Persistent systolic blood pressure \< 90 mmHg or \>180 mmHg despite the use of vasopressor or vasodilators or * Requiring an increment in inotropic-vasopressors over the past two hours just before enrollment: more than 15 mcg/min for norepinephrine and dopamine, more than 10 mcg/min in epinephrine; and more than 50 mcg/ min for phenylephrine. EIT assessments of lung perfusion will only be performed in participants who are already receiving neuromuscular blocking agents (e.g., cisatracurium) at the time of study enrollment. EIT assessments of lung perfusion will not be performed in participants who have the following contraindications to EIT perfusion monitoring: * Hypernatremia (serum sodium \> 150 mEq/L) * Usage of any devices with electric current generation such as pacemaker or internal cardiac defibrillator For controls without acute hypoxemic respiratory failure Inclusion Criteria: * Receiving invasive mechanical ventilation and do not have a diagnosis of acute hypoxemic respiratory failure (PaO2/FiO2 \> 300 mmHg or SpO2/FiO2\> 315) * Presence of an arterial catheter * Admitted to a participating MGH ICU Exclusion Criteria: * Age \< 18 years * Pregnancy or known active breastfeeding * Prisoner or Incarceration * Inability or unwillingness of subject or legal surrogate/representative to give written informed consent

Study sites (1)

MA