Inhaled nitric oxide in persistent pulmonary hypertension of the newborn refractory to high-frequency ventilation
Background:
This study was designed to evaluate the effect of nitric oxide
(NO) on the management of neonates with severe persistent pulmonary
hypertension refractory to high-frequency oscillatory ventilation.
Methods:
The birth weight and the gestational age of infants
were 3125.5 ± 794 g (mean ± SD) and 39 ± 2.4 weeks, respectively. All
neonates were ventilated for an average of 137.5 min (range 90-180 min) prior to
NO therapy. The mean oxygenation index (OI) of all neonates prior to NO was
46.3 ± 5 (mean ± SEM). NO was initially administered at 20 parts per
million (ppm) for at least 2 h and increased gradually by 2 ppm to a maximum of
80 ppm.
Results:
Eighteen infants (75%) responded and six (25%) did not respond to
the treatment. Three neonates died in the responding group, while all the
non-responders died (P = 0.0001). The survival rate was 62.5% among all
neonates. NO significantly decreased OI (P < 0.0001) and improved
the arterial/alveolar (a/A) oxygen ratio (P < 0.0001) within the
first 2 h of NO therapy in 61.1% of the responders. However, the OI and the a/A
oxygen ratio remained almost the same throughout the treatment in the
non-responders and the non-survivors.
Conclusion:
Inhaled NO at 20 ppm, following adequate ventilation for 2 h without
significant response, could be used to identify the majority of the
non-responders in order to seek other alternatives.
Complete Metadata
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|---|---|
| accessLevel | public |
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| description | Background: This study was designed to evaluate the effect of nitric oxide (NO) on the management of neonates with severe persistent pulmonary hypertension refractory to high-frequency oscillatory ventilation. Methods: The birth weight and the gestational age of infants were 3125.5 ± 794 g (mean ± SD) and 39 ± 2.4 weeks, respectively. All neonates were ventilated for an average of 137.5 min (range 90-180 min) prior to NO therapy. The mean oxygenation index (OI) of all neonates prior to NO was 46.3 ± 5 (mean ± SEM). NO was initially administered at 20 parts per million (ppm) for at least 2 h and increased gradually by 2 ppm to a maximum of 80 ppm. Results: Eighteen infants (75%) responded and six (25%) did not respond to the treatment. Three neonates died in the responding group, while all the non-responders died (P = 0.0001). The survival rate was 62.5% among all neonates. NO significantly decreased OI (P < 0.0001) and improved the arterial/alveolar (a/A) oxygen ratio (P < 0.0001) within the first 2 h of NO therapy in 61.1% of the responders. However, the OI and the a/A oxygen ratio remained almost the same throughout the treatment in the non-responders and the non-survivors. Conclusion: Inhaled NO at 20 ppm, following adequate ventilation for 2 h without significant response, could be used to identify the majority of the non-responders in order to seek other alternatives. |
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| identifier | https://healthdata.gov/api/views/2vwj-4fqy |
| issued | 2025-07-13 |
| keyword |
[
"inhaled-nitric-oxide",
"neonatal-outcomes",
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| modified | 2025-09-06 |
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|
| title | Inhaled nitric oxide in persistent pulmonary hypertension of the newborn refractory to high-frequency ventilation |
