Response to inhaled nitric oxide in persistent pulmonary hypertension of the newborn: relationship to baseline oxygenation.
OBJECTIVE
We hypothesized that the magnitude of response to inhaled nitric oxide in persistent pulmonary hypertension of the newborn would correlate with the degree of baseline hypoxemia.


METHODS
We performed a retrospective chart review of 15 consecutive newborn infants with persistent pulmonary hypertension of the newborn treated with inhaled nitric oxide as part of a pilot study. Oxygenation index was calculated for each patient at baseline and 0.5 and 24 hours after the start of therapy and findings were compared by repeated-measures analysis of variance. Correlation was determined between baseline oxygenation index and 24-hour change in oxygenation index.


RESULTS
Patients had a rapid and sustained decrease in oxygenation index (66.7 +/- 14.8 vs 26.3 +/- 5.0 vs 12.9 +/- 2.8, baseline vs 0.5 hour vs 24 hours; p < 0.001) during the study period, and the change in oxygenation index was highly correlated with baseline oxygenation index (r2 = 0.98). Two patients were placed on extracorporeal membrane oxygenation support before the 24-hour time point because of overwhelming sepsis and severe cardiac dysfunction.


CONCLUSIONS
In patients with severe persistent pulmonary hypertension of the newborn, we conclude that the clinical response to inhaled nitric oxide is most dramatic in those patients with the most severe hypoxemia.
Parker
T A
TA
Section of Neonatology, University of Colorado School of Medicine, Denver 80206, USA.
Kinsella
J P
JP
Abman
S H
SH
D000280:Administration, Inhalation; D000704:Analysis of Variance; D001784:Blood Gas Analysis; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000188:drug therapy*; D000860:Hypoxia / Q000097:blood / Q000188:drug therapy; D007231:Infant, Newborn; D008499:Medical Records; D009569:Nitric Oxide / Q000008:administration & dosage* / Q000627:therapeutic use; D010100:Oxygen / Q000097:blood*; D010865:Pilot Projects; D012189:Retrospective Studies; D016896:Treatment Outcome
D009569:Nitric Oxide; D010100:Oxygen