title: Inhaled nitric oxide therapy might reduce the need for hyperventilation therapy in infants with persistent pulmonary hypertension of the newborn.
abstract: 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.
authors.affiliation: Nihon University School of Medicine, Itabashi Hospital, Tokyo, Japan and Saitama Children's Medical Center, Saitama, Japan. hosonos@med.nihon-u.ac.jp
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Hosono
authors.forename: Tutomu
authors.initials: T
authors.lastname: Ohno
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kimoto
authors.forename: Masaki
authors.initials: M
authors.lastname: Shimizu
authors.forename: Shigeru
authors.initials: S
authors.lastname: Takahashi
authors.forename: Kensuke
authors.initials: K
authors.lastname: Harada
mesh_terms: 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
chemical_list: D002245:Carbon Dioxide; D009569:Nitric Oxide; D010100:Oxygen