scholarly journals Inhaled nitric oxide in managing preterm infants with suspected pulmonary hypoplasia

2020 ◽  
Author(s):  
Rashmi Mehta ◽  
Harsha Gowda
Keyword(s):  
Nitric Oxide ◽  
Preterm Infants ◽  
Pulmonary Hypoplasia ◽  
Inhaled Nitric Oxide

scholarly journals Inhaled Nitric Oxide at Birth Reduces Pulmonary Vascular Resistance and Improves Oxygenation in Preterm Lambs

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 378
Author(s):  
Satyan Lakshminrusimha ◽  
Sylvia F. Gugino ◽  
Krishnamurthy Sekar ◽  
Stephen Wedgwood ◽  
Carmon Koenigsknecht ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Pulmonary Vascular Resistance ◽  
Preterm Infants ◽  
Vascular Resistance ◽  
Inhaled Nitric Oxide ◽  
Persistent Pulmonary Hypertension ◽  
Inhaled No ◽  
Birth Preterm

Resuscitation with 21% O2 may not achieve target oxygenation in preterm infants and in neonates with persistent pulmonary hypertension of the newborn (PPHN). Inhaled nitric oxide (iNO) at birth can reduce pulmonary vascular resistance (PVR) and improve PaO2. We studied the effect of iNO on oxygenation and changes in PVR in preterm lambs with and without PPHN during resuscitation and stabilization at birth. Preterm lambs with and without PPHN (induced by antenatal ductal ligation) were delivered at 134 d gestation (term is 147–150 d). Lambs without PPHN were ventilated with 21% O2, titrated O2 to maintain target oxygenation or 21% O2 + iNO (20 ppm) at birth for 30 min. Preterm lambs with PPHN were ventilated with 50% O2, titrated O2 or 50% O2 + iNO. Resuscitation with 21% O2 in preterm lambs and 50%O2 in PPHN lambs did not achieve target oxygenation. Inhaled NO significantly decreased PVR in all lambs and increased PaO2 in preterm lambs ventilated with 21% O2 similar to that achieved by titrated O2 (41 ± 9% at 30 min). Inhaled NO increased PaO2 to 45 ± 13, 45 ± 20 and 76 ± 11 mmHg with 50% O2, titrated O2 up to 100% and 50% O2 + iNO, respectively, in PPHN lambs. We concluded that iNO at birth reduces PVR and FiO2 required to achieve target PaO2.

Inhaled nitric oxide in very preterm infants with severe respiratory distress syndrome

2006 ◽  
Vol 95 (9) ◽  
pp. 1116-1123 ◽  
Author(s):  
Carlo Dani ◽  
Giovanna Bertini ◽  
Marco Pezzati ◽  
Luca Filippi ◽  
Alessandra Cecchi ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Inhaled Nitric Oxide ◽  
Severe Respiratory Distress ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Severe Respiratory Distress Syndrome

scholarly journals Inflammatory Mediators in Tracheal Aspirates of Preterm Infants Participating in a Randomized Trial of Inhaled Nitric Oxide

PLoS ONE ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. e0169352 ◽  
Author(s):  
Mandy Laube ◽  
Elena Amann ◽  
Ulrike Uhlig ◽  
Yang Yang ◽  
Hans W. Fuchs ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Randomized Trial ◽  
Preterm Infants ◽  
Inflammatory Mediators ◽  
Inhaled Nitric Oxide ◽  
Tracheal Aspirates

scholarly journals Effects of inhaled nitric oxide in high risk preterm infants

1997 ◽  
Vol 42 (3) ◽  
pp. 411-411
Author(s):  
Nimish V Subhedar ◽  
Ben N J Shaw
Keyword(s):  
Nitric Oxide ◽  
High Risk ◽  
Preterm Infants ◽  
Inhaled Nitric Oxide

Four Patterns of Response to Inhaled Nitric Oxide for Persistent Pulmonary Hypertension of the Newborn

PEDIATRICS ◽  
1996 ◽  
Vol 98 (4) ◽  
pp. 706-713 ◽  
Author(s):  
Allan P. Goldman ◽  
Robert C. Tasker ◽  
Sheila G. Haworth ◽  
Paul E. Sigston ◽  
Duncan J. Macrae
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Time Course ◽  
Pulmonary Hypoplasia ◽  
Oxygenation Index ◽  
Pediatric Intensive Care ◽  
Inhaled Nitric Oxide ◽  
Persistent Pulmonary Hypertension ◽  
Clinical Role ◽  
Initial Trial

Objective. To determine the clinical role of inhaled nitric oxide (iNO) in the treatment of persistent pulmonary hypertension of the newborn (PPHN). Study Design. Prospective open observational clinical study. Setting. A regional cardiac and pediatric intensive care unit. Methods. Twenty-five consecutive near-term neonates (>35 weeks gestation) with severe PPHN (oxygenation index [OI]> 25) were given a trial of iNO of 20 ppm for 20 minutes. Neonates who showed a greater than 20% improvement in Pao 2 as well as a decrease in the OI to below 40 were defined as responders and continued on this therapy. Results. Four patterns of response emerged to the iNO therapy: Pattern 1 neonates (n = 2) did not respond to the initial trial of iNO—one survived. Pattern 2 neonates (n = 9) responded to the initial trial of iNO, but failed to sustain this response over 36 hours, as defined by a rise in the OI to >40. Six survived, five with extracorporeal membrane oxygenation. Pattern 3 neonates (n = 11) responded to the initial trial of iNO, sustained this response, and were successfully weaned from iNO within 5 days—all survived to discharge. Pattern 4 neonates (n = 3) responded to the initial trial of iNO, but developed a sustained dependence on iNO for 3 to 6 weeks. All three died and lung histology revealed severe pulmonary hypoplasia and dysplasia. These neonates (pattern 4) not only required iNO for a longer period of time than did the sustained responders (pattern 3), but they required significantly higher doses of iNO during their first 5 days of iNO therapy. Conclusions. Early responses to iNO may not be sustained. Neonates with pulmonary hypoplasia and dysplasia may have a decreased sensitivity and differing time course of response to iNO when compared with patients who have PPHN in fully developed lungs.

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