Abnormalities of coagulation related to the use of inhaled nitric oxide before extracorporeal membrane oxygenation.
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.
de Mol
Amerik C
AC
Department of Neonatology, Radbound University Nijmegen Medical Center, Nijmegen, The Netherlands. a.c.demol@cukz.umcn.nl
van Heijst
Arno F J
AF
Brouwers
Marc
M
de Haan
Ton F J
TF
van der Staak
Frans H J M
FH
Liem
Kian D
KD
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*
D014665:Vasodilator Agents; D009569:Nitric Oxide