Neurodevelopmental and medical outcomes of persistent pulmonary hypertension in term newborns treated with nitric oxide.
OBJECTIVE
To determine the medical and neurodevelopmental outcome of children with moderately severe persistent pulmonary hypertension of the newborn (PPHN) treated with or without inhaled nitric oxide (I-NO).


METHODS
Term infants with PPHN and a baseline oxygenation index of 24 +/- 9 at study entry were randomly assigned to early treatment with placebo or initial doses of I-NO (5, 20, and 80 ppm). Outcome was measured at approximately 1 year by frequency of hospitalization, growth, and neurodevelopmental and audiologic evaluation.


RESULTS
Of 155 children enrolled, 144 survived, and there was follow-up for 133. No significant differences between the placebo and the I-NO groups were seen in any long-term outcome. Rehospitalization occurred in 22%, and growth did not differ. The composite neurodevelopment and audiologic outcome showed impairment in 46% of the infants. There were major neurologic abnormalities in 13%, cognitive delays in 30%, and hearing loss in 19% of the infants.


CONCLUSIONS
Moderately severe PPHN at 24 hours after birth is associated with high rates of rehospitalization and disability at 1 year. Adverse outcomes were the same in I-NO and control groups.
Lipkin
Paul H
PH
Department of Pediatrics, Kennedy Krieger Institute, Baltimore, Maryland 21205, USA.
Davidson
Dennis
D
Spivak
Lynn
L
Straube
Richard
R
Rhines
Jared
J
Chang
C T
CT
D000280:Administration, Inhalation; D003072:Cognition Disorders / Q000209:etiology; D002658:Developmental Disabilities / Q000209:etiology* / Q000517:prevention & control; D006319:Hearing Loss, Sensorineural / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D009422:Nervous System Diseases / Q000209:etiology* / Q000517:prevention & control; D009569:Nitric Oxide / Q000008:administration & dosage* / Q000009:adverse effects; D010547:Persistent Fetal Circulation Syndrome / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015430:Weight Gain
D014665:Vasodilator Agents; D009569:Nitric Oxide