Effect of intubation and mechanical ventilation on exhaled nitric oxide in preterm infants with and without bronchopulmonary dysplasia measured at a median postmenstrual age of 49 weeks

摘要

Background Exhaled nitric oxide (eNO) is a marker of established airway inflammation in adults and children, but conflicting results have been reported in preterm infants when postnatal eNO is measured during tidal breathing. This study investigated the extent to which intubation and mechanical ventilation (MV) affect eNO and NO production (V’ _NO ) in preterm infants with and without bronchopulmonary dysplasia (BPD). Patients and methods A total of 176 very low birth weight (VLBW) infants (birth weight Results eNO was significantly correlated with tidal breathing parameters, while V’ _NO was correlated with growth parameters, including age and body length (p? NO (p? NO did not differ significantly in non-ventilated infants and those receiving MV for ≥7 days. Multivariate analysis showed that independent on the duration of MV eNO (p?=?0.003) and V’ _NO (p?=?0.018) were significantly increased in BPD infants comparable with the effects of intubation and MV on eNO (p?=?0.002) and V’ _NO (p?=?0.017). Conclusions Preterm infants with BPD show only weak postnatal increases in eNO and V’ _NO , but these changes may be obscured by the distinct influences of breathing pattern and invasive respiratory support. This limits the diagnostic value of postnatal eNO measurements in the follow-up of BPD infants.