This prospective single-centre pilot evaluated inhaled nitric oxide in adults with cardiogenic shock receiving Impella or ECPELLA support; 11 patients were enrolled and 10 analysed. The primary endpoint was change in mean pulmonary artery pressure at 30 minutes, which decreased from 19.0 to 16.5 mmHg (P=0.004). The baseline-to-24-hour difference was not significant, and no clear improvement in systemic haemodynamic indices was observed. Lactate decreased, but without a control group this temporal change could not be attributed directly to inhaled nitric oxide.
Inhaled nitric oxide was temporally associated with an early reduction in pulmonary artery pressure during Impella-based support. This pilot does not establish clinical benefit or a causal haemodynamic effect.
Study limitation: Only 10 patients were analysed at one centre without a control group, limiting causal interpretation and generalisability.
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