In Reply:—

We presented a brief overview of the perioperative uses of inhaled nitric oxide (NO). Although we covered the most common indications for inhaled NO, the letter by Tanus-Santos correctly suggests that additional uses have been described, such as the management of pulmonary embolism. There are also case reports of the use of inhaled NO in hepato-pulmonary syndrome and after heparin-protamine reactions. Since the publication of our article, inhaled NO has received Food and Drug Administration approval for term and near-term (older than 34 weeks) neonates with hypoxic respiratory failure associated with pulmonary hypertension. It is important to realize that all other uses of inhaled NO are considered “off-label.” Furthermore, consideration of the use of inhaled NO to treat pulmonary hypertension with or without hypoxemia should include its considerable cost.