Results An intent-to-treat analysis revealed that inhaled nitric oxide at 5 ppm did not increase the number of days patients were alive and off assisted breathing (mean [SD],  days in the placebo group and  days in the inhaled nitric oxide group; P = .97; difference, – day [95% confidence interval, – to days]). This lack of effect on clinical outcomes was seen despite a statistically significant increase in PaO 2 that resolved by 48 hours. Mortality was similar between groups (20% placebo vs 23% nitric oxide; P = .54). Days patients were alive following a successful 2-hour unassisted ventilation trial were a mean (SD) of () for placebo and () for nitric oxide patients ( P = .54). Days alive and meeting criteria for extubation were also similar: placebo vs nitric oxide ( P = .89).
Use of QVAR with a spacer device in children less than 5 years of age is not recommended. In vitro dose characterization studies were performed with QVAR 40 mcg/actuation with the OptiChamber and AeroChamber Plus ® spacer utilizing inspiratory flows representative of children under 5 years old. These studies indicated that the amount of medication delivered through the spacing device decreased rapidly with increasing wait times of 5 to 10 seconds as shown in Table 2. If QVAR is used with a spacer device, it is important to inhale immediately.