To prevent an adverse rebound effect when withdrawing NO therapy, ...

[daltonest1984]

To prevent an adverse rebound effect when withdrawing NO therapy, what should you do?
 
  1. Reduce the NO to the lowest effective dose (ideally, less than 5 ppm).
  2. Hyperoxygenate the patient just before discontinuing NO.
  3. Ensure that the patient is hemodynamically stable.
  a. 1 and 2 only
  b. 2 and 3 only
  c. 1 and 3 only
  d. 1, 2, and 3

Question 2

Potential adverse effects associated with NO therapy include which of the following?
 
  1. Poor or paradoxical response
  2. Increased blood clotting
  3. Increased left ventricular filling pressures
  4. Rebound hypoxemia or pulmonary hypertension
  a. 1 and 3 only
  b. 1, 3, and 4 only
  c. 2 and 4 only
  d. 1, 2, 3, and 4

[Jbrasil]

Answer to Question 1

ANS: D
First, the NO level should be reduced to the lowest effective dose (ideally =5 ppm). Second, the patient's condition should be hemodynamically stable, and the patient should be able to maintain adequate oxygenation while breathing a moderate FiO2 (0.4 or less) on low levels of positive end expiratory pressure. Third, the patient should be hyperoxygenated (FiO2, 0.60 to 0.70) just before discontinuation of NO inhalation.

Answer to Question 2

ANS: B
Potential adverse effects associated with NO therapy are listed in Box 41-10.

[daltonest1984]

Excellent

[olderstudent]

Thanks for the timely response, appreciate it