77 Inhaled Nitric Oxide in Preterm Infants of less than 30 Weeks' Gestation with Respiratory Distress Syndrome

Abstract

Background. Inhaled nitric oxide (INO) might favour the prevention of bronchopulmonary dysplasia (BPD) in preterm infants through its anti-inflammatory action, regulatory effect in pulmonary angiogenesis, and minimising lung injury through a reduction in oxygen and ventilatory requirements. Objectives. To test the hypothesis that INO therapy can decrease the incidence of BPD and death in preterm infants with RDS; to evaluate the possible predictive factors of response to INO therapy. Study design. Preterm infants (less than 30 weeks of gestation) received during the first week of life INO, or nothing, if they presented severe RDS (FiO2 >0.50 and a/APO2 <0.15), despite mechanical ventilation and surfactant treatment. Then, to evidence possible differences, the treated infants were classified as non responders and responders. Results. Twenty infants were enrolled in the INO therapy group and 20 in the control group. BPD and death were lees frequent in the INO group than in the control group (50 vs. 90%, p=0.016). A birth weight lower than 750 grams had a significant predictive value for the failure to respond to INO therapy (OR 12; 95% C.I. 1,3 - 113.3). Conclusions. Inhaled NO decreases the incidence of BPD and death in preterm infants with severe RDS without adverse effects. The birth weight may influence the response of preterm infants to INO therapy.