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Guidelines for the safe administration of inhaled nitric oxide.
  1. O I Miller,
  2. D S Celermajer,
  3. J E Deanfield,
  4. D J Macrae
  1. Cardiothoracic Unit, Hospital for Sick Children, London.


Inhaled nitric oxide (NO) is a selective pulmonary vasodilator, potentially useful in the treatment of pulmonary hypertension and ventilation-perfusion mismatch. High doses of inhaled NO and its oxidative product nitrogen dioxide (NO2) may cause acute lung injury. Using a standard infant ventilator, ventilator circuit and test lung, an administration and monitoring strategy has been defined for inhaled NO and these observations validated in eight ventilated infants. In 90% oxygen, doses of inhaled NO > or = 80 parts per million may result in toxic NO2 concentrations.

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