{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T19:29:31Z","timestamp":1779910171028,"version":"3.53.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T00:00:00Z","timestamp":1714694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Interstitial pneumonia is the most common and serious secondary lesion of dermatomyositis. In some cases, patients may develop severe acute pneumonia that can quickly progress to respiratory failure, resulting in high mortality rates. A 57-year-old woman with dermatomyositis and interstitial pulmonary fibrosis experienced severe hypoxemia due to pulmonary infection. Despite receiving various treatments after entering the intensive care unit (ICU), such as anti-infection therapy, lung recruitment, prone position ventilation, sedative and muscle relaxation, the patient\u2019s oxygen saturation continued to decline. Electrical impedance tomography (EIT) monitoring revealed that prone position could not improve ventilation homogeneity. However, the patient\u2019s ventilation\/perfusion (V\/Q) matching significantly improved 10\u2009min after initiation of supine position ventilation combined with inhalation of nitric oxide (iNO). The patient\u2019s PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub> (P\/F) ratio increased from 86\u2009mmHg to 150\u2009mmHg at 30\u2009min post-treatment. iNO treatment continued for 2\u2009days. Then the patient\u2019s condition improved and she was successfully weaned off the ventilator with rigorous monitoring and symptomatic care. The implementation of mechanical ventilation combined with iNO therapy rapidly improved V\/Q matching and oxygenation in a patient with hypoxemia caused by dermatomyositis complicated with interstitial pneumonia. This approach successfully avoided the need for invasive extracorporeal membrane oxygenation (ECMO) support.<\/jats:p>","DOI":"10.3389\/fmed.2024.1371183","type":"journal-article","created":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T13:28:15Z","timestamp":1714742895000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Case report: Inhaled nitric oxide rescued a hypoxemia patient caused by dermatomyositis complicated with interstitial pneumonia"],"prefix":"10.3389","volume":"11","author":[{"given":"Xiaoyan","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiqiang","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanqi","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1097\/01.bor.0000179949.65895.53","article-title":"Interstitial lung disease in polymyositis and dermatomyositis","volume":"17","author":"Fathi","year":"2005","journal-title":"Curr Opin Rheumatol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2683","DOI":"10.1056\/NEJMra051884","article-title":"Inhaled nitric oxide therapy in adults","volume":"353","author":"Griffiths","year":"2005","journal-title":"N Engl J Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"CD002787","DOI":"10.1002\/14651858.CD002787.pub3","article-title":"Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) in children and adults","volume":"2018","author":"Gebistorf","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"292","DOI":"10.7399\/fh.2017.41.2.10533","article-title":"Inhaled nitric oxide in adult patients with acute respiratory distress syndrome","volume":"41","author":"Monsalve-Naharro","year":"2017","journal-title":"Farm Hosp"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1513\/AnnalsATS.202107-864OC","article-title":"A phase-2 exploratory randomized controlled trial of INOpulse in patients with fibrotic interstitial lung disease requiring oxygen","volume":"19","author":"King","year":"2022","journal-title":"Ann Am Thorac Soc"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1016\/j.chest.2020.02.016","article-title":"A randomized, double-blind, placebo-controlled study of pulsed, inhaled nitric oxide in subjects at risk of pulmonary hypertension associated with pulmonary fibrosis","volume":"158","author":"Nathan","year":"2020","journal-title":"Chest"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1736","DOI":"10.1097\/00003246-200006000-00006","article-title":"Effect of inhaled nitric oxide on key mediators of the inflammatory response in patients with acute lung injury","volume":"28","author":"Cuthbertson","year":"2000","journal-title":"Crit Care Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2883","DOI":"10.1097\/01.CCM.0000248727.29055.25","article-title":"Healthcare costs and long-term outcomes after acute respiratory distress syndrome: a phase III trial of inhaled nitric oxide","volume":"34","author":"Angus","year":"2006","journal-title":"Crit Care Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1007\/s001340050982","article-title":"Inhalation of nitric oxide in acute lung injury: results of a European multicentre study. The European Study Group of Inhaled Nitric Oxide","volume":"25","author":"Lundin","year":"1999","journal-title":"Intensive Care Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1001\/jama.2016.0291","article-title":"Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries","volume":"315","author":"Bellani","year":"2016","journal-title":"JAMA"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1551","DOI":"10.1097\/00003246-200108000-00009","article-title":"Acute cor pulmonale in acute respiratory distress syndrome submitted to protective ventilation: incidence, clinical implications, and prognosis","volume":"29","author":"Vieillard-Baron","year":"2001","journal-title":"Crit Care Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1016\/j.jcrc.2013.03.006","article-title":"Inhaled epoprostenol vs. inhaled nitric oxide for refractory hypoxemia in critically ill patients","volume":"28","author":"Torbic","year":"2013","journal-title":"J Crit Care"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1007\/s00134-010-1754-3","article-title":"Sildenafil attenuates pulmonary arterial pressure but does not improve oxygenation during ARDS","volume":"36","author":"Cornet","year":"2010","journal-title":"Intensive Care Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1378\/chest.125.2.580","article-title":"Hemodynamic response to sildenafil, nitric oxide, and iloprost in primary pulmonary hypertension","volume":"125","author":"Leuchte","year":"2004","journal-title":"Chest"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1016\/S0022-5223(95)70089-7","article-title":"In acute lung injury, inhaled nitric oxide improves ventilation-perfusion matching, pulmonary vascular mechanics, and transpulmonary vascular efficiency","volume":"110","author":"Hillman","year":"1995","journal-title":"J Thorac Cardiovasc Surg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1152\/jappl.1993.74.3.1287","article-title":"Inhaled nitric oxide reverses hypoxic pulmonary vasoconstriction without impairing gas exchange","volume":"74","author":"Pison","year":"1985","journal-title":"J Appl Physiol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.jccase.2021.08.003","article-title":"Vaso reactivity test using inhaled nitric oxide for pulmonary arterial hypertension accompanied by severe interstitial lung disease attributed to systemic sclerosis: a case report","volume":"25","author":"Yamaguchi","year":"2021","journal-title":"J Cardiol Cases"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2159","DOI":"10.1056\/NEJMoa1214103","article-title":"Prone positioning in severe acute respiratory distress syndrome","volume":"368","author":"Gu\u00e9rin","year":"2013","journal-title":"N Engl J Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"E381","DOI":"10.1503\/cmaj.140081","article-title":"Effect of prone positioning during mechanical ventilation on mortality among patients with acute respiratory distress syndrome: a systematic review and meta-analysis","volume":"186","author":"Sud","year":"2014","journal-title":"CMAJ"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1446","DOI":"10.1097\/00003246-200207000-00008","article-title":"Prone-position ventilation induces sustained improvement in oxygenation in patients with acute respiratory distress syndrome who have a large shunt","volume":"30","author":"Lee","year":"2002","journal-title":"Crit Care Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1097\/00005344-199504000-00023","article-title":"Nitric oxide (NO) donor molecules: effect of NO release rate on vascular smooth muscle cell proliferation in vitro","volume":"25","author":"Mooradian","year":"1995","journal-title":"J Cardiovasc Pharmacol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1165\/ajrcmb.16.4.9115751","article-title":"Effects of exogenous nitric oxide on neutrophil oxidative function and viability","volume":"16","author":"Daher","year":"1997","journal-title":"Am J Respir Cell Mol Biol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1164\/rccm.202304-0637OC","article-title":"High-dose inhaled nitric oxide in acute hypoxemic respiratory failure due to COVID-19: a multicenter phase II trial","volume":"208","author":"Di Fenza","year":"2023","journal-title":"Am J Respir Crit Care Med"},{"key":"ref24","first-page":"288","article-title":"Inhaling nitric oxide to prevent and cure radiation interstitial pneumonia","volume":"22","author":"Wang","year":"2002","journal-title":"Chin J Radiol Med Prot."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1016\/j.arbr.2020.03.035","article-title":"Changes in ventilation-perfusion mismatch associated with inhaled nitric oxide in a patient with pneumonia that met criteria for acute respiratory distress syndrome","volume":"57","author":"S\u00e1nchez-Corral","year":"2021","journal-title":"Arch Bronconeumol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1164\/rccm.202107-1598IM","article-title":"Inhaled nitric oxide improved refractory hypoxemia through attenuation of intrapulmonary shunt","volume":"205","author":"Wang","year":"2022","journal-title":"Am J Respir Crit Care Med"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s13054-021-03463-2","article-title":"Insight into ECMO, mortality and ARDS: a nationwide analysis of 45, 647 ECMO runs","volume":"25","author":"Friedrichson","year":"2021","journal-title":"Crit Care"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1371183\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T13:28:21Z","timestamp":1714742901000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1371183\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,3]]},"references-count":27,"alternative-id":["10.3389\/fmed.2024.1371183"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1371183","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,3]]},"article-number":"1371183"}}