BMJ  2007;334 (14 April), doi:10.1136/bmj.39183.447338.3A

Editor's Choice

US editor's choice

Readers beware

The first 150 words of the full text of this article appear below.

Don't believe everything you read. That's the message from several articles in this week's BMJ.

Neill Adhikari and colleagues systematically reviewed the results of 12 clinical trials of nitric oxide in the treatment of acute respiratory distress syndrome (doi: 10.1136/bmj.39139.716794.55). A selective vasodilator, nitric oxide has been widely used in intensive care units because of its demonstrated beneficial effects on oxygenization in critically ill patients. But this meta-analysis of small trials totaling more than 1200 patients found no significant effect on hospital mortality and an increased risk of renal dysfunction. In an accompanying editorial, Niall Ferguson discusses the theoretical advantages of nitric oxide in catastrophic respiratory failure (doi: 10.1136/bmj.39168.568692.BE). Unfortunately this seems to be a case when physiological improvements do not lead to better clinical outcomes, which Ferguson calls a "recurring theme in critical care."

A more general but less obvious point is made by Ignacio Ferreira-González . . . [Full text of this article]

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