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


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.

Health Professions

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