2006, Number 5
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ABSTRACTThe nitric oxide (NO) gas produced a selective pulmonary vasodilatator and improves V/Q matching. It is used in newborns, in the first week of life with › 34 weeks of gestation a with hypoxemic respiratory failure, that required mechanical ventilation and with echocardiographic evidence of a persistent pulmonary hypertension (PPH). The dose of NO is started with 20 ppm in at term newborns and it is reduced to 5 ppm, dose giving by 4to 24 hours of treatment. The duration of the treatment is usually less than 5 days. Consider discontinuing when FIO2 ‹ 60% and PaO2 › 60 mmHg. Prolonged exposure to high doses of NO › 40 ppm may cause metahemoglobinemia and increase in delivered NO2. Lung recruitment is vital to the efficacy of NO in the presence of PPHN and severe lung disease, using high frequency oscillatory ventilation (HFOV). The use of NO in patients with congenital diaphragmatic hernia (CDH): A randomized controlled trial showed no difference in extracorporeal membrane oxygenation (ECMO) use with NO-treated and control infants, while NO may not reduce the need for ECMO in CDH patients, it may help stabilize these infants for treatment with ECMO, as well as aid in the transition of ECMO and the treatment of late pulmonary hypertension.
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