Inhaled nitric oxide in preterm and term neonates with hypoxemic respiratory failure and persistent pulmonary hypertension

摘要

AIM: To assess the effects of inhaled nitric oxide (iNO) as a rescue therapy for term and preterm neonates with hypoxemic respiratory failure (HRF). METHODS: Data were collected from retrospective studies at neonatal service of two university children's hospitals. Response to iNO at 5-20 ppm over time and outcome were assessed. RESULTS: Term (n=40) and preterm (n=35) neonates did not differ in age at entry, initial or maintained iNO dose and duration, baseline blood pH and PaCO_2. oxygenation index (OI) at baseline was higher in the term, and significantly decreased after 30 min, 3 and 24 h after iNO. This effect was seen only at 24 h in the preterm. The decline in time weighted OI (TWOI) at 24 h of the treatment was greater in the term than in the preterm (P <0.01). In the subgroup neonates with baseline pH ≥ 7.25, significant decrease in OI was found at 30 min, 3 and 24 h of iNO, but only at 24 h for the subgroup with pH <7.25 (P <0.05). Intracranial or pulmonary hemorrhage was found mainly in the preterm neonates. The survival was 65 % in all the patients. CONCLUSION: iNO improved oxygenation in both term and preterm neonates with HRF, and its response was in favor of term infants or those with high blood pH values at study entry.