title: Neurodevelopmental and medical outcomes of persistent pulmonary hypertension in term newborns treated with nitric oxide.
abstract: 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.
authors.affiliation: Department of Pediatrics, Kennedy Krieger Institute, Baltimore, Maryland 21205, USA.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Lipkin
authors.forename: Dennis
authors.initials: D
authors.lastname: Davidson
authors.forename: Lynn
authors.initials: L
authors.lastname: Spivak
authors.forename: Richard
authors.initials: R
authors.lastname: Straube
authors.forename: Jared
authors.initials: J
authors.lastname: Rhines
authors.forename: C T
authors.initials: CT
authors.lastname: Chang
mesh_terms: 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
chemical_list: D014665:Vasodilator Agents; D009569:Nitric Oxide