Neurodevelopmental outcome in high-risk preterm infants treated with inhaled nitric oxide

Area of Science:

• Neonatal Medicine
• Pediatric Pulmonology
• Clinical Trials

Background:

• Inhaled nitric oxide (iNO) is a treatment for hypoxemic respiratory failure in preterm infants.
• Long-term outcomes of iNO therapy in this population require further investigation.

Purpose of the Study:

• To evaluate the long-term survival and neurodevelopmental status of high-risk preterm infants receiving iNO therapy.
• To assess the impact of iNO on mortality, neurodevelopmental delay, severe neurodisability, and cerebral palsy.

Main Methods:

• A randomized controlled trial comparing iNO therapy to standard care.
• Follow-up assessments included developmental evaluations and neurological examinations at 30 months corrected age.
• Long-term outcome data were collected for all surviving infants.

Main Results:

• No significant differences in long-term mortality were observed between the iNO-treated and control groups (RR 1.65, 95% CI 0.87-3.3).
• Rates of neurodevelopmental delay (RR 0.89, 95% CI 0.37-1.75), severe neurodisability (p=0.12), and cerebral palsy (p=0.53) did not differ significantly between groups.
• Formal assessments were completed in 21 of 22 surviving children at 30 months corrected age.

Conclusions:

• The study found no evidence of a significant effect of iNO on survival in high-risk preterm infants.
• iNO therapy did not demonstrate a significant impact on long-term neurodevelopmental status or cerebral palsy in this cohort.
• These findings suggest that iNO may not alter long-term outcomes in preterm infants with hypoxemic respiratory failure.