Inhaled nitric oxide therapy might reduce the need for hyperventilation therapy in infants with persistent pulmonary hypertension of the newborn.
OBJECTIVE
To determine whether inhaled nitric oxide might reduce the need for excessive respiratory alkalosis to maintain systemic oxygenation in infants with persistent pulmonary hypertension of the newborn (PPHN).


METHODS
A retrospective historical cohort study of 34 infants with PPHN with oxygenation index (OI) of 25 or more, including 19 infants without inhaled nitric oxide (i-NO) therapy (control group) and 15 infants with inhaled nitric oxide therapy (i-NO group) was performed. The initial dose of 10 ppm of i-NO was administered and no responders received the maximum dose of 25 ppm. We evaluated the mortality rate and the change of OI index and PaCO(2) during the first 6 days.


RESULTS
There were no significant differences in characteristics between groups. Two of 15 in the i-NO group and 6 of 19 infants in the control group died during the first 48 h. Baseline OI, PaCO(2) and arterial pH were similar in the two groups. OI in the i-NO group was significantly higher than in the control group between 12 and 96 h. PaCO(2) in the i-NO group was higher than in the control group between 24 and 144 h.


CONCLUSIONS
i-NO therapy for PPHN might improve systemic oxygenation without excessive hypocapnia. However there was no reduction in duration of ventilation support or oxygen supply.
Hosono
Shigeharu
S
Nihon University School of Medicine, Itabashi Hospital, Tokyo, Japan and Saitama Children's Medical Center, Saitama, Japan. hosonos@med.nihon-u.ac.jp
Ohno
Tutomu
T
Kimoto
Hirofumi
H
Shimizu
Masaki
M
Takahashi
Shigeru
S
Harada
Kensuke
K
D000280:Administration, Inhalation; D002245:Carbon Dioxide / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D009569:Nitric Oxide / Q000008:administration & dosage*; D010100:Oxygen / Q000097:blood; D010547:Persistent Fetal Circulation Syndrome / Q000097:blood / Q000188:drug therapy* / Q000628:therapy; D012138:Respiratory Therapy / Q000379:methods; D012189:Retrospective Studies
D002245:Carbon Dioxide; D009569:Nitric Oxide; D010100:Oxygen