NS Tsoi, YK Ng, SL Lee, CY Yeung

Inhaled nitric oxide (NO) at a concentration of 5-80 ppm is a very potent pulmonary vasodilator. Because of its short half life, there is very little effect on the systemic blood pressure. Clinical trials on inhaled NO have shown that it is very effective in the treatment of pulmonary hypertension complicating meconium aspiration syndrome, respiratory distress syndrome and severe pneumonia. Studies on older children and adults also demonstrated clinical improvement in patients with adult respiratory distress syndrome. We adopted the techniques for delivery of NO through pressure-controlled and volume-controlled ventilators. The inhaled NO and NO₂ were monitored using an electrochemical analyser (Pulmonox). To provide additional safety, the concentrations of inhaled NO and NO₂ were verified using Drager tubes, which are very easy to operate. At the same time, the concentration in the environment could be safely monitored with short-term and long-term Drager tubes. By this method, we can avoid the deployment of a laboratory technician to operate the very complicated and expensive chemiluminescence monitor. We describe here the experience of managing seven patients with inhaled NO.