Oxygen Hood Research Articles

Challenges in Selecting the Right Oxygen Delivery Devices in Neonatal Intensive Care Unit in Developing Countries

Abstract Oxygen is a life-saving drug but it may be dangerous if not used properly. Preterm babies are more susceptible to oxygen-induced free radical damage due to their organ immaturity. When supplementing oxygen in newborns, we must evaluate the equipment’s effectiveness, acceptability, tolerance, nasal injuries, and cost-effectiveness. The two most common time-trusted equipment used in neonatal intensive care units (NICUs) are nasal prongs and oxygen hood. The developed countries are using servo-controlled devices and are continuously monitoring the FiO2 and oxygen levels by the analyzer, but it is impractical in developing countries due to the unavailability of the equipment and financial constraints. We are lacking such sophisticated equipment which can monitor all parameters and are servo mode, especially the oxygen hood. Both equipment has got own merits and demerits, and there are no clear-cut guidelines that which one is better. The proper guidelines regarding the use, indications, methods, and monitoring of oxygen therapy in newborn babies are not clear. Many of the staff working in NICU are the ignorant about the nature of complications and side effects and the need for follow-up. This article highlights the rationale of oxygen therapy and saturation policy, methods of weaning, comparison of the efficacy, merits, and demerits, and implications of oxygen delivery devices in the care of newborns in NICU mostly in developing countries.

Prognostic factors and perinatal outcomes in early-onset intrauterine growth restriction due to placental insufficiency

Objective To determine the principal prognostic factors and neonatal outcomes associated with perinatal death in cases of early-onset intrauterine growth restriction (IUGR) due to placental insufficiency and to define the cutoff point for the risk of perinatal death. Methods A retrospective cohort study conducted with 198 pregnant women with a diagnosis of early-onset IUGR (as detected before the 32nd week of gestational age). The association between the dependent variable (perinatal death) and the independent variables was investigated using a multivariate logistic regression model. The area under the receiver operating characteristic (ROC) curve was calculated to determine the sensitivity and specificity of the adjusted model. A significance level of 5% was established for the entire statistical analysis. Results Perinatal deaths occurred in 89 (44.9%) of the 198 fetuses with early-onset IUGR. Birthweight <800 grams (OR: 14.73; 95%CI: 4.13–52.54; p < .001), postnatal need for mechanical ventilation (OR: 24.56; 95%CI: 5.58–108.08; p < .001) and postnatal use of an oxygen hood (OR: 0.09; 95%CI: 0.02–0.39; p = .001) remained significantly associated with neonatal death in the multivariate model. The sensitivity, specificity, positive and negative predictive values for birthweight <800 grams and need for mechanical ventilation as predictors of death were, respectively, 84%, 91%, 88%, 88% and 93%, 71%, 60% and 96%, while the values for use of an oxygen hood were, respectively, 15%, 62%, 15% and 62%. Conclusion The principal determinants of perinatal death in fetuses with early-onset IUGR were birthweight <800 grams, gestational age at delivery <30 weeks and postnatal need for mechanical ventilation as risk factors while postnatal use of an oxygen hood was found to constitute a protective factor.

Rationalising oxygen usage in a level II special newborn care unit in Madhya Pradesh, India

Non-judicious oxygen use in preterm infants is associated with increased risk of retinopathy of prematurity, bronchopulmonary dysplasia and longer hospital stay. Despite established guidelines on oxygen therapy, compliance with the...

Carbon Dioxide Level in Neonatal Incubator: A Comparative Study of Two Baby Air Flow Input Methods in Incubator Chamber

Preterm neonates often have to spend a long time in incubator which simulates necessary enviromental conditions to maintain patients in stable condition. Authors have found neglected problem with Carbon Dioxide (CO2) concentration in newborn inhaled gas when using “oxygen hood” into infant incubator that has not been studied very closely. Methods in this experiement were carried out as condition monitoring while changing some parameters and positions. Results have shown that CO2 level is letally high in some aspects. Situation is alarming as CO2 level in incubator is not limited by current regulation, as IEC60601-2-19: 2009 +A1:2016. Currently the Incubator manufacturers declare that CO2 maximal concentration should be periodically checked by users, which are hospitals. Some commercially available incubators have the maximum allowed CO2 level 8000 ppm, which is much higher than recommended 2000 ppm CO2 level in indoor working place. There is no limitation of maximal level of CO2 using “oxygen hood”, which are specified in incubator operation manual. This paper goal is to show the correlation of CO2 level versus gas flow into oxygen hood.

The use of oxygen hoods in patients failing on conventional high-flow oxygen delivery systems, the effects on oxygenation, mechanical ventilation and mortality rates in hypoxic patients with COVID-19. A Prospective Controlled Cohort Study.

IntroductionEfforts to meet increased oxygen demands in COVID-19 patients are a priority in averting mechanical ventilation (MV), associated with high mortality approaching 76.4–97.2%. Novel methods of oxygen delivery could mitigate that risk. Oxygen hoods/helmets may improve: O2-saturation (SaO2), reduce in-hospital mechanical ventilation and mortality rates, and reduce length of hospitalization in hypoxic Covid-19 patients failing on conventional high-flow oxygen delivery systems.MethodsDesignProspective Controlled Cohort Study.SettingSingle Center.ParticipantsAll patients admitted with a diagnosis of COVID-19 were reviewed and 136/347 patients met inclusion criteria.Study period3/6/2020 to 5/1/2020.136 participants completed the study with known status for all outcome measures.Intervention or exposureOxygen hoods/helmets as compared to conventional high-flow oxygen delivery systems.Main outcome(s) and measure(s)1) Pre and post change in oxygen saturation (SaO2).2) In-hospital Mechanical Ventilation (MV).3) In-hospital Mortality.4) Length of hospitalization.Results136 patients including 58-intervention and 78-control patients were studied. Age, gender, and other demographics/prognostic indicators were comparable between cohorts.Oxygen hoods averted imminent or immediate intubation/MV in all 58 COVID-19 patients failing on conventional high-flow oxygen delivery systems with a mean improvement in SaO2 of 8.8%, p < 0.001.MV rates were observed to be higher in the control 37/78 (47.4%) as compared to the intervention cohort 23/58 (39.7%), a difference of 7.7%, a 27% risk reduction, not statistically significant, OR 95%CI 0.73 (0.37–1.5).Mortality rates were observed higher in the control 54/78 (69.2%) as compared to the intervention cohort 36/58 (62.1%), a difference of 7.1%, a 27% risk reduction, not statistically significant OR 95%CI 0.73 (0.36–1.5).ConclusionOxygen hoods demonstrate improvement in SaO2 for patients failing on conventional high-flow oxygen-delivery systems and prevented imminent mechanical ventilation.In-hospital mechanical ventilation and mortality rates were reduced with the use of oxygen hoods but not found to be statistically significant.The oxygen hood is a safe, effective oxygen-delivery system which may reduce intubation/MV and mortality rates. Their use should be considered in treating hypoxic COVID-19 patients. Further research is warranted.Trial registrationClinicalTrials.gov Identifier: NCT 04407260.

Bartsocas-Papas Syndrome: A Lethal Multiple Pterygium Syndrome

Bartsocas-Papas Syndrome (BPS) is a very rare autosomal recessive syndrome characterised by marked craniofacial deformities, multiple pterygia of various joints, limb and genital abnormalities. It is mostly associated with mutation in the gene encoding Receptor Interacting Serine/Threonine Kinase 4 (RIPK4) required for keratinocyte differentiation. The syndrome is generally lethal and majority of babies die in-utero or in the early neonatal period. This is a report about a neonate born with characteristic clinical features of BPS including severe craniofacial and ophthalmic abnormalities, limb deformities and multiple pterygia at popliteal, axillary and inguinal region. The baby had respiratory distress at birth and was managed conservatively on Continuous Positive Airway Pressure (CPAP)/Oxygen hood and injectable antibiotics for two weeks and then referred for further work-up to a tertiary hospital. The parents took the baby home against the advice of the treating doctors and she subsequently died after 10 days. BPS is associated with high mortality and so all efforts should be directed towards diagnosing it early antenatally when termination of pregnancy is a viable option. This is possible by having a high index of suspicion in couples with consanguineous marriages or with a positive family history.

AB025. Controlled FiO2 therapy to neonates by oxygen hood in the absence of oxygen analyser

AB025. Controlled FiO2 therapy to neonates by oxygen hood in the absence of oxygen analyser

A Novel Approach to Critical Congenital Heart Disease (CCHD) Screening at Moderate Altitude

The American Academy of Pediatrics (AAP) has endorsed Critical Congenital Heart Disease (CCHD) screening using pulse oximetry nationwide, but, however, acknowledges that altitude may impact failure rates and alternative algorithms may be required at high altitudes. We therefore evaluated a modified screening protocol at an altitude of 6200 feet with the hypothesis that modifications could decrease failure rates. We evaluated 2001 well, newborn infants ≥35 weeks gestation using a modified protocol, which included a lower saturation cutoff for the first screen (85% instead of the AAP recommended 90%) and an oxygen hood intervention between the first two screens. Using our modified screening algorithm, we found a 0.3% failure rate, which was similar to the 0.2% sea-level rate and statistically different from the 1.1% rate identified in a recent study at similar altitude. Had the AAP protocol been used, the failure rate would have increased to 0.8%, which is similar to prior reports near this altitude. Echocardiograms were performed on failing newborns with no CCHD identified. A Birth Defects Registry Database review demonstrated one newborn with CCHD was missed after meeting AAP passing criteria. Overall, this study demonstrates that an alternative algorithm can be implemented at moderate altitude with decreased failure rate and comparable false negative rate.

Neonatal outcomes of infants admitted to a large government hospital in Amman, Jordan.

Objective:To describe characteristics and outcomes of Jordanian newborns admitted to a large governmental neonatal intensive care unit (NICU).Methods:Newborns born at the government hospital, Al Bashir, in Amman, Jordan were prospectively enrolled. The study focused on newborns admitted to the NICU and a retrospective chart review was performed. ion included in-hospital mortality, antibiotic days, ventilation, oxygen use, and CRP levels. Rank sum and chi-squared tests were used to compare across outcomes. Logistic regression of hypothesized risk factors with death adjusted for gestational age.Results:Of the 5,466 neonates enrolled from 2/10-2/11, medical records were available for 321/378(84.9%) infants admitted to the NICU. The median gestational age was 36 weeks, median birth weight was 2.3 kg, and 28(8.7%) infants died. The two most common reasons for admission and mortality were respiratory distress syndrome and prematurity. Low Apgar scores and positive CRP were predictors of mortality. Risk factors associated with increased use of antibiotics, oxygen hood, and mechanical ventilation included lower gestational age and prematurity.Conclusion:Infants admitted to the Jordanian NICU have significantly higher median gestational age and birth weights than in developed countries and were associated with significant morbidity and mortality. Continuations of global efforts to prevent prematurity are needed.

Evaluation of adherence to oxygen therapy standards before, during and after oxygen hood administration

Background and Purpose: Oxygen therapy is one of the common treatments for neonates with cardiopulmonary disease. The aim of this study was to evaluate adherence to oxygen therapy standards by nurses before, during and after using oxygen hood. Methods: In this cross-sectional study, 250 cases of nursing care were evaluated before, during and after administration of oxygen hood therapy in preterm infants. The observations were conducted according to the standards of the neonatal intensive care units (NICU) of hospitals affiliated to the Ahvaz University of Medical Sciences. The data collection tools included a self-designed checklist for nursing audit evaluating the performance of NICU nurses working by neonatal oxygen hood, and a demographic profile checklist. The data were analyzed by Chi-square and Spearman tests, using SPSS version 18. Results: The results demonstrated insufficient adherence to the standards of oxygen therapy by 90% of the nurses before neonatal oxygen hood. Moreover, regarding the mentioned standards, 84% and 99.2% of the nurses had moderate and poor performance during and after oxygen therapy, respectively. Conclusion: Considering the poor performance of the NICU nurses before, during and after oxygen therapy, appropriate supervision and training programs for nurses is recommended to promote their capabilities in this regard.

Abstract 11174: A Novel Approach to Critical Congenital Heart Disease (CCHD) Screening at Moderate Altitude

Introduction: Prenatal studies and postnatal physical exam leave 13- 55% of neonates with CCHD undiagnosed leading to presentation in extremis or death. The AHA has endorsed newborn pulse oximetry screening to capture these infants prior to hospital discharge. Moderate altitude can impart higher screening failure rates. We therefore evaluated a modified CCHD screening protocol in an attempt to reduce false positive screenings at a moderate altitude of 6200 feet (1890 m). Methods: We prospectively enlisted well newborn infants greater than 35 weeks. Near 24 hours of life, trained nursing staff performed pulse oximetry on the right hand and either foot. Those with saturations ≤95% with &lt; 3% difference between hand and foot measurements passed. Infants with saturations &lt;86% failed. Infants with saturations between 86-94% or &gt;3% difference in saturations were placed in an oxygen hood with FiO2 designed to replicate sea level atmospheric oxygen tension for 20 minutes to accelerate neonatal transition. These infants were tested again up to 2 additional screens in room air with standard sea level protocol. Providers were notified and echocardiograms ordered for all infants deemed to have failed. Results: A total of 2005 infants completed the protocol. The failure rate was 0.3% (7/2005), which was not different from the sea level rate of 0.2%. Sea level CCHD screening criteria would have given a failure rate of 0.75%. An additional 2.1% (42/2005) had incomplete screening and were not passing at the time the test was stopped. We found 5/7 (71.4%) infants failed secondary to low saturations, 1/7 (14.3%) failed secondary differential saturations, and 1 infant failed for multiple reasons. Three of the seven infants with failing screens were discharged prior to echocardiogram. None of the infants receiving echocardiograms had critical congenital heart disease. Conclusions: We found a failure rate of 0.3% using an alternate algorithm adjusted for altitude. This failure rate approximates the overall screening failures reported at sea level and is significantly lower than prior reports at altitude. Additional research is needed specifically addressing sensitivity and positive predictive value for screening at moderate altitudes.

Light Reduction Capabilities of Homemade and Commercial Incubator Covers in NICU

Reduction of high-risk neonates' exposure to aversive light stimulation is an important component of developmentally supportive care. In neonatal intensive care unit (NICU), usually light is reduced by reducing the room's light level or by using incubator covers. Many types of incubator covers are in use, including homemade and commercial covers. A comparative study was used to determine the light reducing capabilities of 19 homemade incubator covers, 2 commercial covers, and 1 receiving blanket. The covers were tested by covering and uncovering an incubator and an oxygen hood in the NICU during daytime and nighttime lightings. The light reducing capabilities value was determined for each cover using an Extech light dosimeter when the cover was placed over and removed from an oxyhood, and an incubator. The study showed that the light reducing capability of the commercial covers was 91.2%, the homemade covers capability was 72.1%, and the receiving blankets capability was 55.1%. A significant difference between the commercial and homemade covers was found (F = 452.50, P < 0.00). Commercial incubator covers are the most effective covers to achieve light reduction; homemade covers can be effective if made large enough so that they completely cover all sides of the incubator.

Exposure to di(2-ethylhexyl) phthalate in premature neonates in a neonatal intensive care unit in Taiwan

Neonates are exposed to high levels of di(2ethylhexyl) phthalate through numerous medical procedures in the neonatal intensive care unit. Our aim was to assess the contribution of specific medical devices to the di(2-ethylhexyl) phthalate exposure of neonates. Prospective. University hospital. We recruited 32 premature neonates, 20 with very low birth weight (<1500 g) and 12 with low birth weight (<2500 g), and 31 controls at a neonatal intensive care unit from a medical center in central Taiwan. Interventions were based on a clinical need and used standard materials and devices, including endotracheal tubes, continuous positive airway pressure, oxygen hood, intravenous injection, intralipid injection, blood transfusion, orogastric tubes, nasogastric tubes, umbilical venous catheterization, umbilical arterial catheterization, chest tube, and isolate. We recorded the medical procedures of each subject, collected their urine samples, and determined the urinary concentration of three metabolites of di(2-ethylhexyl) phthalate using reversed-phase high-performance liquid chromatography-atmospheric pressure chemical ionization-tandem mass spectrometry. Median levels of di(2-ethylhexyl) phthalate metabolites in premature neonates treated with an endotracheal tube and orogastric tube or nasogastric tube were significantly higher than those not treated with an endotracheal tube, orogastric tube, or nasogastric tube. Median levels of di(2-ethylhexyl) phthalate metabolites in premature neonates treated with intravenous injection were ≥ 2-fold higher than those of healthy controls who received intravenous injections (p = .01). Median levels of three di(2-ethylhexyl) phthalate metabolites were similar in very-low-birth-weight and low-birth-weight neonates. These data suggest that polyvinyl chloride-containing devices are the major defining factor in di(2-ethylhexyl) phthalate exposure levels in neonates in the neonatal intensive care unit. We urge the use of polyvinyl chloride-free or alternative materials in medical devices, especially for endotracheal tubes, orogastric tubes, nasogastric tubes, and intravenous tubing in the neonatal intensive care unit. The health effects of high di(2-ethylhexyl) phthalate exposure on premature neonates in the neonatal intensive care unit is worthy of further investigation.

Safety of recombinant human deoxyribonuclease as a rescue treatment for persistent atelectasis in newborns

BACKGROUND AND OBJECTIVEPulmonary problems are vitally important in newborns. Increased intense and mucoid secretions may lead to atelectasis, pulmonary infections, respiratory distress, prolonged mechanical ventilation or even death. The aim of this study was to evaluate the safety of recombinant human deoxyribonuclease (rhDNase) in the management of persistent atelectasis in term and preterm newborns, unresponsive to the conventional treatment.DESIGN AND SETTINGProspective study of patients admitted to a general community setting of a neonatal intensive care unit between December 2007 and December 2009.PATIENTS AND METHODSThe study included 22 patients (12 premature and 10 term) who were admitted to the neonatal intensive care unit because of respiratory distress and developed atelectasis, and were unresponsive to conventional treatment. Nebulized rhDNase was administered to all patients at a dose of 1 mg/m2 twice daily for 3 days. In patients who did not respond to 3 days of treatment, endotracheal rhDNase was administered at a dose of 1 mg/m2. We assessed the clinical (respiratory rate and oxygen requirement) and radiologic responses (chest radiographic score), recurrence of atelectasis, the need for a repetitive treatment, and mortality rate.RESULTSA clinical and radiologic improvement of atelectasis was observed in 18 of 22 patients following 3 days of nebulized rhDNase treatment. Atelectasis relapsed in 4 patients. Following the administration of combined endotracheal and nebulized rhDNase treatment, an improvement of atelectasis was noted in all four recurrent cases. No adverse events were observed in patients because of the rhDNase treatment.CONCLUSIONSrhDNase treatment is a safe option and may be used as an effective method for the management of persistent atelectasis in newborns, which is resistant to other conventional treatment methods.

Risque d’accumulation du CO 2 lors de l’oxygénothérapie sous enceinte « HOOD » (Étude expérimentale sur banc d’essai)

Objectives Oxygen hood is largely used to deliver O 2 to newborn infants with respiratory failure in the northern region of France. The oxygen flow is set to obtain the target arterial blood oxygen saturation. Thus, O 2 flow delivers into the hood may be below the recommended gas flow of 6 L/min. However, gas flow below 6 L/min exposes to CO 2 rebreathing. The aim of this study was to evaluate the effect of various rates of gas flows on the values of partial pressure of CO 2 into the hood. Material and methods We measured CO 2 and O 2 partial pressure into hoods of two different volumes (4 and 10 L) under two experimental bench test conditions. Protocol 1: gas flow was constant at 6 L/min, while oxygen fraction varied from 0.21 to 1. Partial pressure of CO 2 and O 2 were recorded. Protocol 2: while O 2 fraction was kept constant, oxygen flow varied from 0.5 to 7 L/min (by step of 0.5 L/min). Partial pressure of CO 2 and O 2 were recorded. Results Partial pressure of CO 2 increases proportionally to the decrease in the gas flow delivered into the hood, and reached 14 mmHg at gas flow of 0.5 L/min. Conclusion Risk of CO 2 rebreathing exists as soon as the gas is delivered into the hood at minimal flow rates below 6 L/min.

Index Of Suspicion In The Nursery

Articles| October 01 2010 Index Of Suspicion In The Nursery Neoreviews (2010) 11 (10): e590–e596. https://doi.org/10.1542/neo.11-10-e590 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Index Of Suspicion In The Nursery. Neoreviews October 2010; 11 (10): e590–e596. https://doi.org/10.1542/neo.11-10-e590 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsNeoReviewsPediatricsHospital PediatricsPediatrics In ReviewAAP Grand RoundsAAP NewsAll AAP Sites Search Advanced Search Subjects: Adoption & Foster Care, Community Pediatrics, Hematology/Oncology Topics: hemoglobin, hemorrhage, newborn, nurseries, patau's syndrome, perinatal period, respiratory distress, ultrasonography, chromosomes, anemia You do not currently have access to this content.

Five Fast Fixes

As simulation programs expand to include new courses, we are challenged to furnish patient rooms with the appropriate equipment within a budget. When running a simulation for pediatrics, obstetrics, or the neonatal intensive care unit, infants may need an oxygen hood, a warmer, or bili lights. If you have any METI® manikins, you have the materials you can convert into two of these items, if you kept the packing material for the computer (Figure 1). This is the easiest conversion of an item into medical equipment that I can remember making. With a labeler, print the words Infant Warmer and Bilirubin Lights in large, easy-to-read letters. Apply one of the labels to the front edge of the polystyrene packing used to ship the computer and the other label to the back edge of the polystyrene packing (Figure 2, Figure 3). Hang your new equipment from the ceiling at the height needed for a warmer or for bilirubin lights. If you don't count the initial cost of the METI® equipment, your infant warmer and bili lights are free! Figure 2Polystyrene packing, now phototherapy lights. View Large Image Figure Viewer Figure 3Polystyrene packing, now an infant warmer. View Large Image Figure Viewer

An overview of recent applications of computational modelling in neonatology

This paper reviews some of our recent applications of computational fluid dynamics (CFD) to model heat and mass transfer problems in neonatology and investigates the major heat and mass-transfer mechanisms taking place in medical devices, such as incubators, radiant warmers and oxygen hoods. It is shown that CFD simulations are very flexible tools that can take into account all modes of heat transfer in assisting neonatal care and improving the design of medical devices.

Index of Suspicion in the Nursery

A 2,435-g male infant is born at 38 weeks gestational age to a 22-year-old G2P1001 woman who is blood group O+ and negative for group B Streptococcus. Labor had been induced for intrauterine growth restriction. Rupture of membranes with clear fluid occurred 3 hours before delivery, and the baby is delivered by emergency cesarean section for fetal bradycardia. Apgar scores are 8 at 1 minute and 8 at 5 minutes. The baby is suctioned by bulb and nasogastric tube. At 8 minutes of age, the baby's lungs sound wet, with a pulse oximetry reading of 68%, and 40% blow-by oxygen is started. By 15 minutes of age, he is breathing room air with a pulse oximetry reading of 98%. Physical examination in the newborn nursery yields normal results, with a Ballard score of 39 weeks, weight between the 10th and 25th percentiles, length at the 75th percentile, and head circumference at the 25th percentile. He has one low temperature of 35.4°C initially, but the capillary blood glucose measurements are 59 mg/dL (3.3 mmol/L) or more. He does well on formula feedings, with a weight loss of 15 g at 12 hours and 40 g at 36 hours. At 45 hours of age, after an uneventful hospital stay, the baby develops tachypnea and moderate intercostal and subcostal retractions. His pulse oximetry reading is 85% to 89%. He is placed on oxygen by nasal cannula, and an evaluation is undertaken that reveals the source of his respiratory distress. A 23-day-old male infant presents to the clinic because of persistent crying. Yesterday, he was seen in the emergency department, where colic was diagnosed. Today, his mother appears overwhelmed, stating that the baby cries throughout the day and night. She is concerned that the infant has abdominal pain or pain in his left …

Nitric Oxide Administration Using an Oxygen Hood: A Pilot Trial

BackgroundWe have shown earlier that inhaled nitric oxide (iNO) administered by oxygen hood reduces pulmonary hypertension in an animal model (J Perinatol 2002; 22:50-6). Our objective in this study was to determine feasibility of iNO by oxygen hood in neonates with elevated alveolar-arterial oxygen gradients (A-aDO2).Methods/Principal FindingsMasked randomized controlled pilot trial. Inclusion criteria were: gestation≥34 weeks, age<7 days, with post-ductal arterial line, and A-aDO2 400–600. Infants were randomized to study gas (iNO 20 ppm or equivalent O2 flow) for 1 hr which was then weaned over the next 4 hours. Primary outcome was PaO2 one hour post-randomization. Four infants each were randomized to iNO or O2 (controls). Two of the four infants given iNO had an increase in PaO2 of >100 torr, while oxygenation was unchanged in the controls. Methemoglobinemia and other adverse effects were not noted in any infant. Environmental levels of NO and NO2 were minimal (<1 ppm) at >0.3 m from the hood.ConclusionsAdministration of iNO by oxygen hood is feasible. Larger randomized controlled trials are required to measure the efficacy and determine an appropriate target population for this technique.Trial RegistrationClinicalTrials.gov NCT00041548