title: Abnormalities of coagulation related to the use of inhaled nitric oxide before extracorporeal membrane oxygenation.
abstract: OBJECTIVE
  Evaluation of the influence of previous inhaled nitric oxide (iNO) treatment on the occurrence of clotting complications and disseminated intravascular coagulation during extracorporeal membrane oxygenation (ECMO).
  
  
  METHODS
  Retrospective study in newborns treated with venoarterial ECMO during a 5-yr period.
  
  
  METHODS
  Neonatal intensive care unit of a university medical center.
  
  
  METHODS
  A total of 59 newborns with severe respiratory insufficiency treated with venoarterial ECMO.
  
  
  METHODS
  Patients received iNO before ECMO (iNO group) or not (control group).
  
  
  RESULTS
  There were no differences between the groups for patient characteristics and medication use before ECMO, except for norepinephrine. After correction for diagnosis and duration of ECMO, significantly more clotting complications and disseminated intravascular coagulation as individual variables were seen in the iNO group. For the combination of clotting complications and disseminated intravascular coagulation, there was a significantly higher prevalence in the iNO group.
  
  
  CONCLUSIONS
  In our population, we found a remarkable relationship between clotting complications or disseminated intravascular coagulation and iNO use before ECMO treatment, which needs further prospective research before conclusions can be drawn.
authors.affiliation: Department of Neonatology, Radbound University Nijmegen Medical Center, Nijmegen, The Netherlands. a.c.demol@cukz.umcn.nl
authors.forename: Amerik C
authors.initials: AC
authors.lastname: de Mol
authors.forename: Arno F J
authors.initials: AF
authors.lastname: van Heijst
authors.forename: Marc
authors.initials: M
authors.lastname: Brouwers
authors.forename: Ton F J
authors.initials: TF
authors.lastname: de Haan
authors.forename: Frans H J M
authors.initials: FH
authors.lastname: van der Staak
authors.forename: Kian D
authors.initials: KD
authors.lastname: Liem
mesh_terms: D000280:Administration, Inhalation; D001778:Blood Coagulation Disorders / Q000139:chemically induced*; D004211:Disseminated Intravascular Coagulation / Q000139:chemically induced; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009569:Nitric Oxide / Q000008:administration & dosage*; D011300:Preoperative Care; D012131:Respiratory Insufficiency / Q000628:therapy; D012189:Retrospective Studies; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D014665:Vasodilator Agents; D009569:Nitric Oxide