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General Critical Care

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A study investigated the use of inhaled prostacyclin as a therapy for Acute Respiratory Distress Syndrome (ARDS including COVID-19 patients) was published in "Respiratory Research". The study was a prospective randomized controlled single-blind multicenter trial conducted across Germany from March 2019 with final follow-up on 12th of August 2021. Patients with moderate to severe ARDS were included and randomized to receive either inhaled prostacyclin or sodium chloride (Placebo). The primary outcome was the oxygenation index on Day 5 of therapy. Secondary outcomes included mortality, secondary organ failure, disease severity and adverse events.

The primary analysis showed that prostacyclin improved oxygenation by 20 mmHg more than Placebo but this result was not statistically significant (p = 0.17). However, secondary analysis showed that oxygenation was significantly improved in patients with ARDS who were COVID-19-positive (34 mmHg, p = 0.04). Mortality did not differ between groups and secondary organ failure and adverse events were similar in both groups.

In conclusion, while the primary result of the study was negative, the data suggest that inhaled prostacyclin might have a beneficial treatment effect in improving hypoxemia for patients with COVID-19 induced ARDS.

Haeberle, H.A., Calov, S., Martus, P. et al. Inhaled prostacyclin therapy in the acute respiratory distress syndrome: a randomized controlled multicenter trial. Respir Res24, 58 (2023).

Faisal Rawagah
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