Abstract
Objective: Although unlicensed, inhaled nitric oxide (NO) therapy is now widely used in the United Kingdom. Our aim was to produce guidelines for the clinical application of inhaled NO in adult intensive care practice, based upon the current level of published information.
Methods: The published data regarding the use of inhaled NO in the acute respiratory distress syndrome and right-sided cardiac failure was presented, analysed and discussed. Recommendations based on these data as well as on current experience in the United Kingdom were formulated.
Design: An expert group comprising intensive care specialists from within the United Kingdom, representatives from the European Society of Intensive Care Medicine and the Society of Critical Care Medicine and individuals from the Departments of Health and Industry related to the field was assembled.
Results: United Kingdom guidelines for the indications, contraindications, dose, delivery, monitoring and scavenging of inhaled NO therapy were produced.
Conclusions: The need for additional quality research to establish evidence of efficacy and safety was emphasized. The guidelines are designed to act within the context of current practice and knowledge and should be revised as further data emerge.
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With support of the Consensus Conference Group:
Dr. N. Appleyard, Consultant, Intensive Therapy Unit, Northern General Hospital, Sheffield; Dr. I. Armstrong, Consultant, Intensive Therapy Unit, Royal Infirmary of Edinburgh, Edinburgh; Dr. S. Baudouin, Consultant, ITU, Royal Victoria Infirmary, Newcastle; Dr. R. Beale, Consultant, Intensive Therapy Unit, Guy’s Hospital, London; Dr. A. Bodenham, Consultant, Intensive Therapy Unit, Leeds General Infirmary, Leeds; Mr. C. Gray, Medical Devices Agency, London; Dr. S. Brett, Senior Registrar, Thoracic Medicine Unit, The Royal Brompton Hospital, London; Dr. T. Clutton-Brock, Consultant, Adult Intensive Therapy Unit, Queen Elizabeth Hospital, Birmingham; Dr. S. Dean, Consultant, Intensive Therapy Unit, St. James University Hospital, Leeds; Dr. T. Gould, Consultant, Intensive Therapy Unit, Bristol Royal Infirmary, Bristol; Dr. I. Grant, Consultant, Intensive Therapy Unit, Western General Hospital, Edinburgh; Dr. K. Kelly, Senior Registrar, Intensive Therapy Unit, Western General Hospital, Edinburgh; Dr. P. Lawler, Consultant, Intensive Therapy Unit, South Cleveland Hospital, Middlesborough; Dr. K. Lowry, Consultant, Intensive Therapy Unit, Belfast, Grosvenor Road, Belfast; Dr. D. Macrae, Consultant, Cardiac Intensive Therapy Unit, Hospital for Sick Children, Great Ormond Street, London; Mr. M. McGovern, Senior Medical Officer, Department of Health, London; Dr. N. Moore, Consultant, Groby Road Hospital, Leicester; Dr. A. Oduro, Cardiac Intensive Therapy Unit, Papworth Hospital, Cambridge; Mr. D. Peel, British Standards Institution, London; Dr. A. Petros, Consultant, Paediatric ITU, The Royal Brompton Hospital, London.
Authors affiliations: Drs. Latimer and Young and Professors’ Evans, Higenbottam and Webster sit on the nitric oxide advisory panel to Ohmeda. Drs. Cuthbertson and Young and Professor Webster were investigators for the AGA Ab European inhaled nitric oxide in ALI study.
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Cuthbertson, B.H., Stott, S., Webster, N.R. et al. UK guidelines for the use of inhaled nitric oxide therapy in adult ICUs. Intensive Care Med 23, 1212–1218 (1997). https://doi.org/10.1007/s001340050488
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DOI: https://doi.org/10.1007/s001340050488