title: The role of nitric oxide in the treatment of neonatal pulmonary hypertension.
abstract: Nitric oxide production appears to be decreased in infants with persistent pulmonary hypertension (PPHN). Inhaled nitric oxide may improve oxygenation by two mechanisms: increased pulmonary blood flow and improved ventilation-perfusion matching. Nitric oxide inhalation has been tested in newborns with PPHN, congenital heart diseases, and bronchopulmonary dysplasia. We present a review of the articles concerning inhaled nitric oxide for infants with PPHN. Overall, 59% of the neonates had an initial improvement in oxygenation in response to nitric oxide inhalation. A sustained response was observed in 60% of the infants. Patients with extrapulmonary shunting, clear chest radiographs, and adequate lung volume seem to have a better response, whereas patients with congenital diaphragmatic hernia, severe sepsis, and alveolar capillary dysplasia are more likely to fail. To define the benefit-risk ratio, six prospective randomized trials are currently in progress.
authors.affiliation: Division of Neonatology, University of Alabama at Birmingham 35233-7335, USA.
authors.forename: G
authors.initials: G
authors.lastname: Mariani
authors.forename: E S
authors.initials: ES
authors.lastname: Barefield
authors.forename: W A
authors.initials: WA
authors.lastname: Carlo
mesh_terms: D000818:Animals; D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy; D006330:Heart Defects, Congenital / Q000150:complications / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007231:Infant, Newborn; D009569:Nitric Oxide / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D009569:Nitric Oxide