Cardiopulmonary effects of nebulized sodium nitroprusside in term infants with hypoxic respiratory failure.
OBJECTIVE
To study whether nebulized nitroprusside (neb-NP) improves oxygenation in term infants with hypoxic respiratory failure (HRF).


METHODS
We studied 22 newborn term infants (gestational age, 39.7+/-0.4 weeks [mean+/-SEM]; birth weight, 3.6+/-0.1 kg) with hypoxia (Pao2<100 mm Hg) during mechanical ventilation (Fio2=1.0). Sodium nitroprusside (5 mg followed by 25 mg) was nebulized into the inspiratory arm of the ventilator circuit. Vital signs and arterial blood gas values were recorded after 20 minutes at each dose and before and after initiation of inhaled nitric oxide (iNO).


RESULTS
Pao2 increased significantly with 5 mg neb-NP (from 64.6+/-5.6 to 90.1+/-15.3 mm Hg, P=.04) and with 25 mg neb-NP (113.2+/-20.4 mm Hg, P=.009). Differences between mean Pao2 at 5 mg versus 25 mg neb-NP were also statistically significant (P=.03). When comparing the effect of neb-NP to iNO, the treatment-induced increases in Pao2 were similar (52.1+/-18.7 vs 62.2+/-18.2 mm Hg, respectively, P=not significant).


CONCLUSIONS
Neb-NP causes a dose-dependent increase in oxygenation in term infants with HRF, similar in magnitude to iNO* Neb-NP may be beneficial in infants with HRF when iNO is not readily available.
Mestan
Karen K L
KK
Department of Pediatrics, the University of Chicago Children's Hospital, Chicago, Illinois, USA.
Carlson
Angela D
AD
White
Melissa
M
Powers
John A
JA
Morgan
Sherwin
S
Meadow
William
W
Schreiber
Michael D
MD
D000280:Administration, Inhalation; D001921:Brain / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D000860:Hypoxia / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D007223:Infant; D008168:Lung / Q000503:physiopathology; D008297:Male; D009569:Nitric Oxide / Q000008:administration & dosage; D009599:Nitroprusside / Q000008:administration & dosage / Q000627:therapeutic use*; D010092:Oximetry; D010100:Oxygen / Q000378:metabolism; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D014665:Vasodilator Agents; D009599:Nitroprusside; D009569:Nitric Oxide; D010100:Oxygen