The respiratory therapist has initiated nitric oxide for an infant with severe refractory hypoxemia. The initial dose was 20 ppm and titrated up to 30 ppm for the last 1 hour due to lack of response. However, there still is no response. What should the therapist do?

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Quizplus · Accepted Answer

Studies have suggested that optimal dosing is usually in the 20- to 30-ppm range. Some infants will not respond positively. The Neonatal Inhaled Nitric Oxide Study (NINOS) trial indicated that only 6% of nonresponders will demonstrate a positive response when given NO at 80 ppm. Typically, a response would be seen almost immediately; however, it is recommended that determining an infant's response lasts no longer than 30 minutes to 1 hour to limit the exposure to NO.

The Respiratory Therapist Has Initiated Nitric Oxide for an Infant