Developmental outcomes in persistent pulmonary hypertension treated with nitric oxide therapy.
BACKGROUND
The aim of the present study was to assess 3 year auditory and neurodevelopmental outcomes of persistent pulmonary hypertension of the newborn (PPHN) before and after introducing inhaled nitric oxide (i-NO) therapy, and to detect the clinical factors affecting poor outcome.


METHODS
A retrospective historical cohort study of 26 survivors with PPHN with oxygenation index (OI) >or=25 (13 infants without i-NO therapy, control group; 13 with i-NO therapy, i-NO group) was performed. Auditory brainstem response (ABR) at 6 and 12 months and neurodevelopmental outcomes at 3 years of age were evaluated.


RESULTS
ABR abnormalities at 6 months were observed in one infant in the i-NO group and six in the control group (P = 0.04). At 1 year, one infant in the i-NO group and two of six infants in the control group still had ABR abnormality. In the i-NO group, two children had abnormal neurodevelopmental outcomes, as compared with five children in the control group at 3 year follow up. Two children in the control group and no children in the i-NO group had hearing loss at 3 years of age. Hypocapnea (P = 0.04) and elevated creatine phosphokinase (P = 0.04) were found to be most predictive for neurodevelopmental abnormality.


CONCLUSIONS
Avoidance of excessive hypocapnea via introduction of i-NO therapy might reduce both ABR and neurodevelopmental abnormalities.
Division of Neonatology, Saitama Children's Medical Center, Saitama, Japan. hosonos@med.nihon-u.ac.jp
Shigeharu
S
Hosono
Tutomu
T
Ohno
Hirofumi
H
Kimoto
Masaki
M
Shimizu
Shigeru
S
Takahashi
Kensuke
K
Harada
D000280:Administration, Inhalation; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D015331:Cohort Studies; D016057:Evoked Potentials, Auditory, Brain Stem; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009569:Nitric Oxide / Q000008:administration & dosage*; D010547:Persistent Fetal Circulation Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies
D001993:Bronchodilator Agents; D009569:Nitric Oxide