Equipment review: Pulmonary uptake and modes of administration of inhaled nitric oxide in mechanically-ventilated patients

17cc-2-1-009 Introduction Inhaled nitric oxide (NO) is a selective pulmonary vasodilator which reduces pulmonary artery pressure and increases arterial oxygenation in patients with adult respiratory distress syndrome (ARDS). Despite these beneficial effects, inhaled NO has not yet been shown to improve outcome. During artificial ventilation, it can be administered in the downstream of the ventilator into the inspiratory limb of the ventilatory circuit, or can be mixed with oxygen and nitrogen in the upstream part of the system. Because of its simplicity and low cost, administration into the inspiratory limb is most commonly used in southern Europe, whereas in the United States and northern Europe, the system of administration into the upstream is more popular. Each of these systems has its own advantages and disadvantages.