Audit of early experience with inhaled nitric oxide in New Zealand neonatal intensive care units.
OBJECTIVE
To audit the use of inhaled nitric oxide for the treatment of persistent pulmonary hypertension of the newborn in New Zealand neonatal intensive care units.


METHODS
Prospective data collection on all infants treated with inhaled nitric oxide in neonatal intensive care units in the 20-month period from first use to December 1995. Data included perinatal factors, principal diagnosis, echocardiogram results, ventilation details and response to nitric oxide, adverse reactions and outcome.


RESULTS
Twenty-eight infants received nitric oxide in three centres, all bar one being 36 weeks or more gestation. Overall survival was 68%. Thirteen infants (46%) responded to nitric oxide treatment, 12 (92%) surviving. Seven (47%) of non-responders survived. Infants with primary pulmonary hypertension or meconium aspiration syndrome had 90% survival and more often responded to nitric oxide than infants with congenital diaphragmatic hernia (40% survival) or pulmonary hypoplasia (no survivors). No serious complications of treatment were recorded.


CONCLUSIONS
Inhalational nitric oxide was not universally successful treatment for pulmonary hypertension of the newborn but was likely to have been life-saving in a proportion of cases. Future studies may allow better case selection. Ongoing audit of this new treatment is warranted.
Darlow
B
B
Department of Paediatrics, Christchurch School of Medicine. bdarlow@chmeds.ac.nz
Kempthorne
P
P
Knight
D
D
Wong
M
M
D000280:Administration, Inhalation; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D006548:Hernia, Diaphragmatic / Q000188:drug therapy; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008171:Lung Diseases / Q000188:drug therapy* / Q000473:pathology; D008471:Meconium Aspiration Syndrome / Q000188:drug therapy; D009520:New Zealand; D009569:Nitric Oxide / Q000008:administration & dosage*; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*