Chapter 18

Question 1

1. Nitric Oxide (NO)

Answer 1

Normally produced by all cells

Vasodilation of pulmonary vascular bed

Better perfusion

Inhaled (iNO)preferred because the NO only gets to the blood vessels that are connected to open alveoli therefore dilating only blood vessels that can pick up O2

Question 2

2. Treatment of Nitric Oxide (Diseases)

Answer 2

Hypoxic respiratory failure of newborn (pulmonary hypertension of newborn) near or full term ARDS, not shown to work in adults possibly in children in combination with HFV

Question 3

3. Doses of Nitric Oxide (NO)

Answer 3

Titrate into vent circuit via a specialty machine

• Starting dose anywhere from 1-80ppm
• Recommended start from .gov 18ppm

Question 4

4. What are the Complications of Nitric Oxide (NO)?

Answer 4

Nitrogen Dioxide (NO2)

• Byproduct of NO and O2
• Toxic to patient and health care providers
• Add NO gas right before the wye so less time to mix –
• Scavenge the exhaled gas

Question 5

5. Methemoglobin

Answer 5

Can combine with hemoglobin decreasing O2 carrying capacity

Question 6

6. Helium-Oxygen Inert gas

Answer 6

Lighter gas gets around obstructions better 
80:20
70:30
Loses benefits if less than 70% He Non-rebreather
Vent circuit
Deliver aerosol medications 
Flowmeters
    - 80:20 multiply flow rate by 1.8 
    - 70:30 multiply flow rate by 1.6

Question 7

Misc

Answer 7

CO2 or N2 to lower FiO2 to less than 0.21 Anesthetic gases