Experience with mobile inhaled nitric oxide during transport of neonates and children with respiratory insufficiency to an extracorporeal membrane oxygenation center.
OBJECTIVE
To share our experience with the use of inhaled nitric oxide (iNO) during the transport of ventilated neonates and children to an extracorporeal membrane oxygenation (ECMO) center and to discuss the efficacy and safety of iNO use in this situation.


METHODS
Case note review of 55 consecutive patients transported while receiving iNO to Glenfield Hospital, Leicester, UK, for consideration of ECMO.


METHODS
Retrospective case note review.


METHODS
The clinical condition of each patient recorded at arrival of the transport team at the referring hospital, during transport, and at arrival at Glenfield Hospital. Preclinical and postclinical conditions were compared using the paired Student's t-test.


RESULTS
Overall data showed a significant improvement in transcutaneous oximetry measurements (Spo(2): 84.8% preclinical, 90.6% postclinical; p = .006) and Pao(2) (59 torr [7.87 kPa] preclinical, 84 torr [11.23 kPa] postclinical; p = .001) during transport in our patient group. Based on limited safety data, no untoward events or toxic metabolites were observed with iNO therapy during transport.


CONCLUSIONS
iNO does appear to improve oxygenation during transfer of patients for ECMO in our series. Based on limited safety data, iNO appears safe to use in transport.
Westrope
Claire
C
Heartlink ECMO Centre, Glenfield Hospital, Leicester, UK.
Roberts
Neil
N
Nichani
Sanjiv
S
Hunt
Carmel
C
Peek
Giles J
GJ
Firmin
Richard
R
D000280:Administration, Inhalation; D001785:Blood Gas Monitoring, Transcutaneous; D016638:Critical Illness; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use*; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000188:drug therapy*; D012189:Retrospective Studies; D014187:Transportation of Patients / Q000379:methods*
D009569:Nitric Oxide