Respiratory function during infancy in survivors of the INNOVO trial.
BACKGROUND
Despite encouraging reports suggesting that inhaled nitric oxide (iNO) appear to improve outcome in hypoxemic term and near term infants by improving oxygenation and reducing need for ECMO, the long-term benefits of iNO remain unclear. This study aimed to compare lung function at approximately 1 year in infants who were and were not randomly allocated to iNO as part of their neonatal management for severe respiratory failure at birth. Furthermore, results were compared to lung function of healthy infants.


METHODS
Maximal expiratory flow at functional residual capacity (V'maxFRC) was measured at approximately 1 year of age (corrected for any prematurity) in survivors of the INNOVO trial. Results were expressed as Z-scores, adjusted for sex and body size, based on data from healthy controls using identical techniques.


RESULTS
Technically satisfactory results were obtained in 30 infants (53% < 34 weeks gestation), 19 of whom were randomized to receive iNO V'maxFRC. Z-score was significantly reduced in infants with prior respiratory failure, whether or not they had been allocated to iNO (mean (SD) Z-score: -2.0 (1.2) and -2.6 (1.1), respectively, 95% CI difference; iNO vs. no iNO: -0.3; 1.6, P = 0.2). There was significant respiratory morbidity in both groups during the first year of life.


CONCLUSIONS
These results suggest that airway function remains reduced at 1 year of age following severe respiratory failure at birth, whether or not iNO is administered.
Hoo
Ah-Fong
AF
Portex Anaesthesia, Intensive Therapy and Respiratory Medicine Unit, UCL Institute of Child Health, London, UK. a.hoo@ich.ucl.ac.uk
Beardsmore
Caroline S
CS
Castle
Rosemary A
RA
Ranganathan
Sarath C
SC
Tomlin
Keith
K
Field
David
D
Elbourne
Diana
D
Stocks
Janet
J
D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009569:Nitric Oxide / Q000494:pharmacology* / Q000627:therapeutic use*; D010366:Peak Expiratory Flow Rate; D016032:Randomized Controlled Trials as Topic; D012131:Respiratory Insufficiency / Q000188:drug therapy* / Q000503:physiopathology*; D012720:Severity of Illness Index
D009569:Nitric Oxide