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Published on: May 4, 2021
Inhaled nitric oxide in term and preterm infants
1Neonatal Intensive Care Unit, Infant Breathing Disorders Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. Krishnamurthy-Sekar@ouhsc.edu
Summary
Inhaled nitric oxide (NO) therapy improves oxygenation in term infants with hypoxemic respiratory failure. However, its use in premature infants requires caution due to potential risks like bleeding and requires further research.
Area of Science:
- Neonatal Medicine
- Respiratory Physiology
- Pharmacology
Background:
- Nitric oxide (NO) is a potent vasodilator gas.
- Impaired NO production can lead to pulmonary hypertension.
- NO inhalation therapy targets pulmonary vascular resistance.
Purpose of the Study:
- To evaluate the efficacy and safety of inhaled nitric oxide (NO) in neonatal respiratory conditions.
- To assess the impact of inhaled NO on oxygenation and pulmonary vascular resistance in term infants.
- To explore the potential benefits and risks of inhaled NO in premature neonates.
Main Methods:
- Administration of inhaled NO at 20 parts per million in term infants.
- Observational analysis of outcomes including need for extracorporeal membrane oxygenation (ECMO).
- Review of studies investigating inhaled NO in premature infants, focusing on bleeding risk and chronic lung disease.
Main Results:
- Inhaled NO (20 ppm) reduced pulmonary vascular resistance and improved oxygenation in term infants, potentially decreasing ECMO need.
- Inhaled NO is an approved therapy for severe hypoxemic respiratory failure in term neonates.
- In premature infants, inhaled NO may increase bleeding risk and decrease platelet aggregation, raising concerns for intraventricular hemorrhage.
Conclusions:
- Inhaled NO is a valuable therapeutic option for term infants with severe hypoxemic respiratory failure.
- The use of inhaled NO in premature neonates requires careful consideration due to potential adverse effects, including increased risk of intraventricular hemorrhage.
- Further research under approved protocols is necessary to clarify the role and safety of inhaled NO in premature infants, particularly regarding chronic lung disease prevention.
