Effect of Inhaled Nitric Oxide Therapy in Adults With Moderate-to-Severe Acute Respiratory Distress Syndrome

Exclusion Criteria

• •Known allergy to iNO.
• •Congenital methemoglobinemia.
• •End-stage chronic lung disease (e.g., lung cancer, prior pneumonectomy/lung transplant).
• •Shock (norepinephrine \>0.5 μg/kg/min or equivalent for \>6 hours) at treatment initiation.
• •Pulmonary hypertension (PASP \>45 mmHg by echo or mPAP ≥25 mmHg by catheterization).
• •Serum creatinine \>2.5 mg/dL (221 μmol/L).
• •Major bleeding (e.g., intracranial, pulmonary) or platelet count \<20×10⁹/L.
• •Expected ICU/mechanical ventilation \<24 hours.
• •Pre-enrollment ECMO therapy.
• •Any investigator-assessed unsuitability for the study.