Case Report: The role of nitric oxide inhalation and prone positioning ventilation in oxygen improvement in patients with refractory hypoxemia following acute type A aortic dissection surgery: two cases report and literature review
Refractory hypoxemia following Acute Type A Aortic Dissection (ATAAD) surgery presents a significant clinical challenge. How to improve the refractory hypoxemia after ATAAD surgery is very critical for achiving perfect outcome of these patients. We report two cases of severe hypoxemia after ATAAD su...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-07-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1627953/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850082592978632704 |
|---|---|
| author | Xiaofang Wang Xiaofang Wang Kangwei Sun Kangwei Sun Weijun Yang Xia Shao MinJian Kong Wei Cui Lixue Wang Gensheng Zhang Gensheng Zhang Gensheng Zhang |
| author_facet | Xiaofang Wang Xiaofang Wang Kangwei Sun Kangwei Sun Weijun Yang Xia Shao MinJian Kong Wei Cui Lixue Wang Gensheng Zhang Gensheng Zhang Gensheng Zhang |
| author_sort | Xiaofang Wang |
| collection | DOAJ |
| description | Refractory hypoxemia following Acute Type A Aortic Dissection (ATAAD) surgery presents a significant clinical challenge. How to improve the refractory hypoxemia after ATAAD surgery is very critical for achiving perfect outcome of these patients. We report two cases of severe hypoxemia after ATAAD surgery that improved with inhaled nitric oxide (iNO) and prone positioning ventilation (PPV) therapy, despite traditional treatments including ventilator parameter optimization, performance of recruitment maneuvers, administration of glucocorticoids, diuresis and/or CRRT used for maintenance of a negative fluid balance, and secretion aspiration via fiberoptic bronchoscopy. Finally, these two patients were successful weaned from mechanical ventilation and subsequent discharge from the hospital.We provide the successful experience in the application of combination treatment of iNO and PPV in patients with refractory hypoxemia after ATAAD surgery, which will pave the way for the following randomized controlled clinical trials. |
| format | Article |
| id | doaj-art-bbfcf8bd13044cfab3955ead98761f5e |
| institution | DOAJ |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-bbfcf8bd13044cfab3955ead98761f5e2025-08-20T02:44:29ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-07-011210.3389/fcvm.2025.16279531627953Case Report: The role of nitric oxide inhalation and prone positioning ventilation in oxygen improvement in patients with refractory hypoxemia following acute type A aortic dissection surgery: two cases report and literature reviewXiaofang Wang0Xiaofang Wang1Kangwei Sun2Kangwei Sun3Weijun Yang4Xia Shao5MinJian Kong6Wei Cui7Lixue Wang8Gensheng Zhang9Gensheng Zhang10Gensheng Zhang11Department of Cardiovascular Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Emergency Medicine, Dongyang People’ Hospital of Wenzhou Medical University, Dongyang, Zhejiang, ChinaDepartment of Cardiovascular Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Cardiovascular Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Cardiovascular Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Breast Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaKey Laboratory of Multiple Organ Failure (Zhejiang University), Ministry of Education, Hangzhou, Zhejiang, ChinaDepartment of Critical Care Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, ChinaRefractory hypoxemia following Acute Type A Aortic Dissection (ATAAD) surgery presents a significant clinical challenge. How to improve the refractory hypoxemia after ATAAD surgery is very critical for achiving perfect outcome of these patients. We report two cases of severe hypoxemia after ATAAD surgery that improved with inhaled nitric oxide (iNO) and prone positioning ventilation (PPV) therapy, despite traditional treatments including ventilator parameter optimization, performance of recruitment maneuvers, administration of glucocorticoids, diuresis and/or CRRT used for maintenance of a negative fluid balance, and secretion aspiration via fiberoptic bronchoscopy. Finally, these two patients were successful weaned from mechanical ventilation and subsequent discharge from the hospital.We provide the successful experience in the application of combination treatment of iNO and PPV in patients with refractory hypoxemia after ATAAD surgery, which will pave the way for the following randomized controlled clinical trials.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1627953/fullnitric oxideprone positioningaortic dissectionhypoxemiacase report |
| spellingShingle | Xiaofang Wang Xiaofang Wang Kangwei Sun Kangwei Sun Weijun Yang Xia Shao MinJian Kong Wei Cui Lixue Wang Gensheng Zhang Gensheng Zhang Gensheng Zhang Case Report: The role of nitric oxide inhalation and prone positioning ventilation in oxygen improvement in patients with refractory hypoxemia following acute type A aortic dissection surgery: two cases report and literature review Frontiers in Cardiovascular Medicine nitric oxide prone positioning aortic dissection hypoxemia case report |
| title | Case Report: The role of nitric oxide inhalation and prone positioning ventilation in oxygen improvement in patients with refractory hypoxemia following acute type A aortic dissection surgery: two cases report and literature review |
| title_full | Case Report: The role of nitric oxide inhalation and prone positioning ventilation in oxygen improvement in patients with refractory hypoxemia following acute type A aortic dissection surgery: two cases report and literature review |
| title_fullStr | Case Report: The role of nitric oxide inhalation and prone positioning ventilation in oxygen improvement in patients with refractory hypoxemia following acute type A aortic dissection surgery: two cases report and literature review |
| title_full_unstemmed | Case Report: The role of nitric oxide inhalation and prone positioning ventilation in oxygen improvement in patients with refractory hypoxemia following acute type A aortic dissection surgery: two cases report and literature review |
| title_short | Case Report: The role of nitric oxide inhalation and prone positioning ventilation in oxygen improvement in patients with refractory hypoxemia following acute type A aortic dissection surgery: two cases report and literature review |
| title_sort | case report the role of nitric oxide inhalation and prone positioning ventilation in oxygen improvement in patients with refractory hypoxemia following acute type a aortic dissection surgery two cases report and literature review |
| topic | nitric oxide prone positioning aortic dissection hypoxemia case report |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1627953/full |
| work_keys_str_mv | AT xiaofangwang casereporttheroleofnitricoxideinhalationandpronepositioningventilationinoxygenimprovementinpatientswithrefractoryhypoxemiafollowingacutetypeaaorticdissectionsurgerytwocasesreportandliteraturereview AT xiaofangwang casereporttheroleofnitricoxideinhalationandpronepositioningventilationinoxygenimprovementinpatientswithrefractoryhypoxemiafollowingacutetypeaaorticdissectionsurgerytwocasesreportandliteraturereview AT kangweisun casereporttheroleofnitricoxideinhalationandpronepositioningventilationinoxygenimprovementinpatientswithrefractoryhypoxemiafollowingacutetypeaaorticdissectionsurgerytwocasesreportandliteraturereview AT kangweisun casereporttheroleofnitricoxideinhalationandpronepositioningventilationinoxygenimprovementinpatientswithrefractoryhypoxemiafollowingacutetypeaaorticdissectionsurgerytwocasesreportandliteraturereview AT weijunyang casereporttheroleofnitricoxideinhalationandpronepositioningventilationinoxygenimprovementinpatientswithrefractoryhypoxemiafollowingacutetypeaaorticdissectionsurgerytwocasesreportandliteraturereview AT xiashao casereporttheroleofnitricoxideinhalationandpronepositioningventilationinoxygenimprovementinpatientswithrefractoryhypoxemiafollowingacutetypeaaorticdissectionsurgerytwocasesreportandliteraturereview AT minjiankong casereporttheroleofnitricoxideinhalationandpronepositioningventilationinoxygenimprovementinpatientswithrefractoryhypoxemiafollowingacutetypeaaorticdissectionsurgerytwocasesreportandliteraturereview AT weicui casereporttheroleofnitricoxideinhalationandpronepositioningventilationinoxygenimprovementinpatientswithrefractoryhypoxemiafollowingacutetypeaaorticdissectionsurgerytwocasesreportandliteraturereview AT lixuewang casereporttheroleofnitricoxideinhalationandpronepositioningventilationinoxygenimprovementinpatientswithrefractoryhypoxemiafollowingacutetypeaaorticdissectionsurgerytwocasesreportandliteraturereview AT genshengzhang casereporttheroleofnitricoxideinhalationandpronepositioningventilationinoxygenimprovementinpatientswithrefractoryhypoxemiafollowingacutetypeaaorticdissectionsurgerytwocasesreportandliteraturereview AT genshengzhang casereporttheroleofnitricoxideinhalationandpronepositioningventilationinoxygenimprovementinpatientswithrefractoryhypoxemiafollowingacutetypeaaorticdissectionsurgerytwocasesreportandliteraturereview AT genshengzhang casereporttheroleofnitricoxideinhalationandpronepositioningventilationinoxygenimprovementinpatientswithrefractoryhypoxemiafollowingacutetypeaaorticdissectionsurgerytwocasesreportandliteraturereview |