A 54-year-old man with severe ARDS is ventilated with TV 6 mL/kg IBW, PEEP 16 cmH2O, FiO2 0.8. He is prone and paralysed. PaO2/FiO2 is 68 mmHg. The te...

Question

A 54-year-old man with severe ARDS is ventilated with TV 6 mL/kg IBW, PEEP 16 cmH2O, FiO2 0.8. He is prone and paralysed. PaO2/FiO2 is 68 mmHg. The team considers adding inhaled epoprostenol (prostacyclin) as a rescue therapy. What is the advantage of inhaled epoprostenol over inhaled nitric oxide in ARDS?

Accepted Answer

Inhaled epoprostenol produces similar selective pulmonary vasodilation and oxygenation improvement as iNO but is significantly cheaper, does not require specialised delivery systems, and does not produce toxic metabolites (NO produces methaemoglobin and nitrogen dioxide)

Answer

Epoprostenol is more effective at reducing mortality

Answer

Epoprostenol causes systemic hypertension

Answer

Epoprostenol has better evidence for mortality benefit

Answer

Epoprostenol can be given intravenously for the same pulmonary effect

uk-fficm MCQ (SBA): ARDS - Rescue Therapies