Echocardiographic investigation of inhaled nitric oxide in newborn babies with severe hypoxaemia.
Nitric oxide inhalation can benefit newborn babies with right-to-left extrapulmonary shunt (EPS). Using doppler ultrasound, we compared the effects of nitric oxide on systemic oxygenation and mean pulmonary-blood-flow velocity (MPBFV) in severely hypoxic babies with or without EPS. With a median (interquartile range) dose of 20 (32) parts per million, oxygenation index decreased significantly in both groups (EPS, 49 [19] vs 11 [9]; non-EPS, 40 [11] vs 20 [13]). The decrease was significantly greater in the EPS group. MPBFV increased significantly in the EPS group (18 [4] vs 29 [8] m/s) only. Nitric oxide may improve systemic oxygenation in neonates with severe hypoxaemia secondary to EPS by increasing pulmonary blood flow, and in those without EPS by improving ventilation-perfusion matching.
Rozé
J C
JC
Department of Neonatology, Hôpital Universitaire, Nantes, France.
Storme
L
L
Zupan
V
V
Morville
P
P
Dinh-Xuan
A T
AT
Mercier
J C
JC
D000280:Administration, Inhalation; D001783:Blood Flow Velocity; D015150:Echocardiography, Doppler; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007231:Infant, Newborn; D007234:Infant, Premature; D009569:Nitric Oxide / Q000008:administration & dosage / Q000494:pharmacology*; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy; D011651:Pulmonary Artery / Q000502:physiology; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications; D014692:Ventilation-Perfusion Ratio
D009569:Nitric Oxide; D010100:Oxygen