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Nitric Protocol (June 2000)
Brigham & Women's Hospital, Boston, MA
Inhaled Nitric Oxide (INO)
Protocol for Newborns with Hypoxemic Respiratory Failure
  1. INCLUSION CRITERIA
  2. EXCLUSION CRITERIA
  3. COMMUNICATIONS
  4. CALCULATIONS
  5. APPLICATION
Inclusion Criteria
    1. infant requiring assisted ventilation for hypoxic respiratory failure
    2. Indwelling arterial line
    3. GA >= 34 weeks
    4. diagnosis of one of the following:
        a. PPHN
        b. RDS
        c. Aspiration syndrome (meconium, blood or amnionic fluid)
        d. pneumonia
        e. sepsis
        f. suspected pulmonary hypoplasia
    5. An OI >25 on two ABGs at least 30 minutes apart.
    6. Lung recruitment and other PPHN therapy optimized prior to initiating iNO (e.g.. surfactant therapy, alkalosis, hemodynamic support)
 

Exclusion Criteria:
    1. Decision not to provide full treatment
    2. Known structural heart disease (excluding PDA and atrial level shunts)
    4. Jet ventilation (any other HiFi is acceptable \

Communication
        Process for Obtaining Nitric & InoVent

Calculations

MAP FiO2 PaO2 
                O.I. = 


To figure O.I., enter data in the boxes above, & then click "calculate". Note: your browser must support Javascript, or this will not work.

O.I. = (MAP X FiO2 X 100)/PaO2

For instance, if your MAP is 11, FiO2 is 1.00 and PaO2 is 44, your O.I. is 25 and you must call the Medical Director.

Therapy Recommendations