UK GUIDELINES FOR THE USE OF INHALED NITRIC-OXIDE THERAPY IN ADULT ICUS

Objective: Although unlicensed, inhaled nitric oxide (NO) therapy is n ow widely used in the United Kingdom. Our aim was to produce guideline s for the clinical application of inhaled NO in adult intensive care p ractice, based upon the current level of published information. Method s: The published data regarding the use of inhaled NO in the acute res piratory distress syndrome and right-sided cardiac failure was present ed, analysed and discussed. Recommendations based on these data as wel l as on current experience in the United Kingdom were formulated. Desi gn: An expert group comprising intensive care specialists from within the United Kingdom, representatives from the European Society of Inten sive Care Medicine and the Society of Critical Care Medicine and indiv iduals from the Departments of Health and Industry related to the fiel d was assembled. Results: United Kingdom guidelines for the indication s, contraindications, dose, delivery, monitoring and scavenging of inh aled NO therapy were produced. Conclusions: The need for additional qu ality research to establish evidence of efficacy and safety was emphas ized. The guidelines are designed to act within the context of current practice and knowledge and should be revised as further data emerge.