title: ABO blood group is associated with response to inhaled nitric oxide in neonates with respiratory failure.
abstract: BACKGROUND
  Inhaled nitric oxide (iNO) reduces death or need for extracorporeal membrane oxygenation (ECMO) in infants with persistent pulmonary hypertension of the newborn (PPHN). However, the response to iNO is variable and only 50-60% of infants demonstrate a response to iNO. It is not known why only some infants respond to iNO. Adults and children with blood groups B or AB do not respond as well to iNO as those with blood groups O/A.
  
  
  RESULTS
  To determine if blood group was associated with iNO response in newborn infants, a retrospective medical record review was done of infants admitted to a regional NICU from 2002-9 with a diagnosis of PPHN. Data were collected during the first twelve hours post-initiation of treatment. Of 86 infants diagnosed with PPHN, 23 infants had blood group A [18 received iNO], 21 had group B [18 with iNO], 40 had group O [36 with iNO], and 2 had group AB [both received iNO]. Change in PaO(2)/FiO(2) was less in infants with blood group A, of whom less than half were responders (ΔPaO(2)/FiO(2)>20%) at 12 h versus 90% of infants with either O or B. Race, sex, birth weight, gestational age, Apgar scores at 1 and 5 minutes, and baseline PaO(2)/FiO(2) were similar among groups. Outcomes including need for ECMO, death, length of ventilatory support, length of iNO use, and hospital stay were statistically not different by blood groups.
  
  
  CONCLUSIONS
  Our results indicate that blood group influences iNO response in neonates. We hypothesize that either there is genetic linkage of the ABO gene locus with vasoregulatory genes, or that blood group antigens directly affect vascular reactivity.
authors.affiliation: Department of Pediatrics, Centers for Free Radical Biology and Pulmonary Injury Repair Center, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
authors.forename: George T
authors.initials: GT
authors.lastname: El-Ferzli
authors.forename: Mackenzie
authors.initials: M
authors.lastname: Dreher
authors.forename: Rakesh P
authors.initials: RP
authors.lastname: Patel
authors.forename: Namasivayam
authors.initials: N
authors.lastname: Ambalavanan
mesh_terms: D000017:ABO Blood-Group System; D000280:Administration, Inhalation; D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D001784:Blood Gas Analysis; D002648:Child; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care; D010100:Oxygen / Q000097:blood / Q000378:metabolism; D010547:Persistent Fetal Circulation Syndrome / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D012131:Respiratory Insufficiency / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000017:ABO Blood-Group System; D009569:Nitric Oxide; D010100:Oxygen