Inhaled nitric oxide and inhaled prostacyclin in acute respiratory distress syndrome: what is the evidence?

Crit Care Clin. 2011 Jul;27(3):561-87. doi: 10.1016/j.ccc.2011.05.001.


The mortality for acute respiratory distress syndrome remains unacceptably high. Two vasodilators, inhaled prostacyclin and inhaled nitric oxide, are reviewed in this article. Knowledge of inhaled prostacyclin has grown substantially in the past 30 years, but less research exists about its utility in acute respiratory distress syndrome. Inhaled prostacyclin and other prostaglandin derivatives are used in acute respiratory distress syndrome with increasing frequency. Currently, only randomized controlled trials exist for inhaled nitric oxide in acute respiratory distress syndrome patients. Randomized controlled trials with consistent dosing methods are needed for both vasodilators to better define their role in the treatment of acute respiratory distress syndrome.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Inhalation
  • Combined Modality Therapy
  • Epoprostenol / administration & dosage
  • Epoprostenol / therapeutic use*
  • Humans
  • Nitric Oxide / administration & dosage
  • Nitric Oxide / therapeutic use*
  • Patient Positioning
  • Randomized Controlled Trials as Topic
  • Respiration, Artificial
  • Respiratory Distress Syndrome / drug therapy*
  • Respiratory Distress Syndrome / therapy
  • Vasodilator Agents / administration & dosage
  • Vasodilator Agents / therapeutic use*


  • Vasodilator Agents
  • Nitric Oxide
  • Epoprostenol