Nitric Oxide (inhaled)

What is inhaled Nitric Oxide?

Inhaled Nitric Oxide (iNO) is a gas that is given into the lungs. It decreases blood pressure in the lungs and increases the amount of oxygen in the blood.

Why does my child need iNO?

Your child is in the intensive care unit with severe breathing problems, including high blood pressure in the lungs. The high blood pressure causes some blood to bypass the lungs, reducing the amount of oxygen in your child's blood. At times we use iNO to prevent lung damage for premature infants.

How is iNo given?

A machine, called the INOvent, will be connected into the ventilator that is helping your child breathe. The INOvent will deliver the precise amount of iNO that your child needs in addition to the oxygen the ventilator is giving.

If your child is going to respond to iNO, we should see it almost immediately. Usually, iNO is used for 2 to 4 days. Your child could be on it for as little as 2 hours, or possibly up to a month.

What are the benefits of iNO?

Because iNO can improve oxygen levels in the blood, your child may need less help from the ventilator. Less use of the ventilator can decrease or prevent lung injury.

What are the risks of iNO?

Two problems could occur. First, if iNO is used for a long time with a lot of oxygen, nitrogen dioxide can form. Nitrogen dioxide is a harmful gas that can injure the lungs. The amount of nitrogen dioxide in your child's system will be monitored at all times. If the nitrogen dioxide levels rise, the iNO will be stopped.

The second problem is the effect of nitric oxide in the bloodstream. After iNO is given into the lungs it is absorbed into the bloodstream. If too much of this gas is absorbed it can affect the red blood cells' ability to carry oxygen around the body. The medical term for this is methemoglobinemia. Your child's blood will be monitored closely and if the methemoglobin levels start to rise, the iNO will be stopped.

What else do I need to know?

INO has been researched for the last 13 years in infants and children. Infants and children who have high blood pressure in the lungs without severe lung disease have the best outcomes. The Food and Drug Administration (FDA) approved this therapy in December 1999.

Questions?

This sheet is not specific to your child but provides general information. If you have any questions, please ask the doctor, respiratory therapist or nurse.

This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Minnesota Family Resource Center library, or visit www.childrensmn.org/educationmaterials.