Inhaled Nitric Oxide in the Premature Newborn

Abstract

Early reports of inhaled nitric oxide (iNO) therapy in near-term and term newborns with hypoxemic respiratory failure and persistent pulmonary hypertension described marked improvements in gas exchange. 1 Kinsella J.P. Neish S.R. Shaffer E. Abman S.H. Low-dose inhalational nitric oxide in persistent pulmonary hypertension of the newborn. Lancet. 1992; 340: 819-820 Abstract PubMed Scopus (632) Google Scholar , 2 Roberts J.D. Polaner D.M. Lang P. Zapol W.M. Inhaled nitric oxide in persistent pulmonary hypertension of the newborn. Lancet. 1992; 340: 818-819 Abstract PubMed Scopus (737) Google Scholar Subsequent randomized trials demonstrated that iNO decreased the need for extracorporeal life support in this population. 3 Clark R.H. Kueser T.J. Walker M.W. Southgate W.M. Huckaby J.L. Perez J.A. et al. Randomized, controlled trial of low-dose inhaled nitric oxide treatment of persistent pulmonary hypertension of the newborn. N Engl J Med. 2000; 17 (469-74): 342 Google Scholar , 4 Neonatal Inhaled Nitric Oxide Study GroupInhaled nitric oxide in full-term and nearly full-term infants with hypoxic respiratory failure. N Engl J Med. 1997; 336: 597-604 Crossref PubMed Scopus (788) Google Scholar iNO is uniquely suited to the treatment of persistent pulmonary hypertension of the newborn because of its selectivity for the pulmonary circulation and the absence of apparent short-term toxicities when used at low doses. See related article, p 16 See related article, p 16 Neurodevelopmental Outcomes of Premature Infants with Severe Respiratory Failure Enrolled in a Randomized Controlled Trial of Inhaled Nitric OxideThe Journal of PediatricsVol. 151Issue 1PreviewWe hypothesized that inhaled nitric oxide (iNO) would not decrease death or neurodevelopmental impairment (NDI) in infants enrolled in the National Institute of Child Health and Human Development Preemie iNO Trial (PiNO) trial, nor improve neurodevelopmental outcomes in the follow-up group. Full-Text PDF