case_images: PMC11100410_01
case_images: Chest CT of the patient. (A) Chest CT showed increased texture in both lungs with patchy/streaky hyperdense shadows with blurred edges (before hospitalization). (B) Chest CT exhibited bilateral pneumonia with local consolidation (before iNO). (C) Chest CT re-examination displayed a significant improvement in the absorption of inflammation compared to earlier (on day 13).
case_images: fmed-11-1371183-g001.jpg
case_images: PMC11100410_01_fmed-11-1371183-g001.jpg
case_images: fig1
case_images: Chest computed tomography (CT) scans revealed bilateral pneumonia (Figure 1A). Chest CT scan revealed bilateral pneumonia with localized consolidation (Figure 1B). After 13 days of treatment (Table 1), there was a significant improvement in gas exchange (Figure 4) and chest CT (Figure 1C), with PAP decrease to 23 mmHg.
case_images: Ventilation and perfusion before and after inhaling NO in the supine position assessed by electrical impedance tomography (EIT). First row, before inhaled nitric oxide (iNO). Second row, after iNO for 10 min. First column, ventilation distribution, ventilated regions were marked in purple to white (high). Second column, perfusion distribution, perfused regions were marked in green to red (high). Third column, distribution of regional ventilation/perfusion (V/Q) matching. Regions with perfusion only were marked in blue (shunt), ventilation only were marked in green (dead space), and V/Q matching in yellow. The bottom table, changes of V/Q matching before and after iNO therapy.
case_images: fmed-11-1371183-g002.jpg
case_images: PMC11100410_01_fmed-11-1371183-g002.jpg
case_images: fig2
case_images: V/Q ratio showed a decrease in ventilation from 47.98 to 43.04% after iNO, the pulmonary shunt decreased from 12.10 to 11.52%. Ventilation and perfusion became more closely matched (from 39.92 to 45.43%) (Figure 2). iNO treatment continued at 10-20 ppm in the first two days, and no further prone position ventilation was performed.
case_images: The parameter settings of the patient's ventilator. VT, tidal volume; RR, respiration rate; Pplat, plateau pressure; PEEP, positive end-expiratory pressure; DP, driving pressure.
case_images: fmed-11-1371183-g003.jpg
case_images: PMC11100410_01_fmed-11-1371183-g003.jpg
case_images: fig3
case_images: Under close monitoring, ventilator parameters were adjusted based on the respiratory mechanics of the patient and gas exchange (Figure 3).
case_images: The gas exchange of the patient. P/F, PaO2/FiO2 ratio.
case_images: fmed-11-1371183-g004.jpg
case_images: PMC11100410_01_fmed-11-1371183-g004.jpg
case_images: fig4
case_images: After 13 days of treatment (Table 1), there was a significant improvement in gas exchange (Figure 4) and chest CT (Figure 1C), with PAP decrease to 23 mmHg.