Early Inhaled Nitric Oxide Therapy in Premature Newborns with Respiratory Failure

• Published in: The New England journal of medicine Vol. 355; no. 4; pp. 354 - 364
• Main Authors: Kinsella, John P, Cutter, Gary R, Walsh, William F, Gerstmann, Dale R, Bose, Carl L, Hart, Claudia, Sekar, Kris C, Auten, Richard L, Bhutani, Vinod K, Gerdes, Jeffrey S, George, Thomas N, Southgate, W. Michael, Carriedo, Heather, Couser, Robert J, Mammel, Mark C, Hall, David C, Pappagallo, Mariann, Sardesai, Smeeta, Strain, John D, Baier, Monika, Abman, Steven H
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 27.07.2006
• Subjects: Administration, Inhalation; Biological and medical sciences; Birth Weight; Bronchopulmonary Dysplasia - epidemiology; Bronchopulmonary Dysplasia - prevention & control; Drug dosages; FDA approval; Female; General aspects; Hemorrhage; Humans; Hypertension; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight; Intracranial Hemorrhages - prevention & control; Leukomalacia, Periventricular - prevention & control; Lung Diseases - therapy; Male; Medical sciences; Newborn babies; Nitric oxide; Nitric Oxide - administration & dosage; Nitric Oxide - adverse effects; Nitrogen dioxide; Pneumology; Respiration, Artificial - adverse effects; Respiratory distress syndrome; Respiratory Distress Syndrome, Newborn - mortality; Respiratory Distress Syndrome, Newborn - therapy; Respiratory system : syndromes and miscellaneous diseases; Respiratory therapy; Studies; Survival Analysis; Ventilation; Human; Medicine; Premature; Newborn; Treatment; Respiratory failure; Respiratory disease; Nitric oxide; Early; Inhalation
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa060442

In this multicenter, randomized trial of preterm newborns with a birth weight from 500 to 1250 g and with respiratory failure, low-dose inhaled nitric oxide did not significantly reduce death or bronchopulmonary dysplasia overall but reduced this risk in infants with a birth weight of 1000 g or more and reduced the risk of brain injury in the cohort overall. These results support the potential benefits of low-dose inhaled nitric oxide in preterm infants with respiratory failure. Low-dose inhaled nitric oxide did not significantly reduce death or bronchopulmonary dysplasia overall but reduced this risk in infants with a birth weight of 1000 g or more and reduced the risk of brain injury in the cohort overall. Early reports of inhaled nitric oxide therapy showed acute and sustained improvement in oxygenation in term newborns with persistent pulmonary hypertension. 1 , 2 Subsequently, randomized, controlled trials of inhaled nitric oxide in term newborns with persistent pulmonary hypertension confirmed that this selective pulmonary vasodilator improves oxygenation and reduces the need for extracorporeal membrane oxygenation. 3 , 4 Previous studies suggested that inhaled nitric oxide can improve gas exchange in premature newborns with hypoxemia caused by the respiratory distress syndrome or persistent pulmonary hypertension. 5 – 8 Although the Food and Drug Administration (FDA) approved inhaled nitric oxide for use in term newborns, the safety and . . .