72‐h Infusion of Prostacyclin in Mechanically Ventilated Patients with Pulmonary Infection and Endotheliopathy

pmc.ncbi.nlm.nih.gov December 23, 2024

Acute respiratory failure (ARF) is common in critically ill patients, and 50% of patients in intensive care units require mechanical ventilation.

The COVID‐19 pandemic revealed that COVID‐19 infection induced ARF caused by damage to the microvascular pulmonary endothelium.

In a randomized clinical trial, mechanically ventilated COVID‐19 patients with severe endotheliopathy, as defined by soluble thrombomodulin (sTM) ≥ 4 ng/mL, were randomized to evaluate the effect of a 72‐h infusion of low‐dose prostacyclin 1 ng/kg/min or placebo.

Twenty‐eight‐day mortality was 21.9% versus 43.6% in the prostacyclin and the placebo groups, respectively (RR 0.50; CI 0.24 to 0.96 p = .06).