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A Novel Inhalation Mask System to Deliver High Concentrations of Nitric Oxide Gas in Spontaneously Breathing Subjects
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Methaemoglobinaemia risk factors with inhaled nitric oxide therapy in newborn infants

I Hamon1, H Gauthier-Moulinier, E Grelet-Dessioux

  • 1Maternite Regionale Universitaire, Nancy, France.

Acta Paediatrica (Oslo, Norway : 1992)
|May 12, 2010
PubMed
Abstract

Insights

Methaemoglobin (MetHb) elevation is rare in neonates receiving low-dose inhaled nitric oxide (iNO). High iNO doses and high oxygen concentrations are risk factors for elevated MetHb levels.

Area of Science:

  • Neonatal medicine
  • Pharmacology
  • Clinical chemistry

Background:

  • Inhaled nitric oxide (iNO) is used for hypoxic neonates.
  • iNO can react with hemoglobin to form methaemoglobin (MetHb).
  • MetHb monitoring during iNO therapy is debated due to low-dose usage.

Purpose of the Study:

  • Evaluate the incidence of elevated MetHb in neonates treated with iNO.
  • Identify risk factors associated with elevated MetHb during iNO therapy.

Main Methods:

  • Analysis of 452 MetHb measurements from 163 neonates (81 premature, 82 term/near-term).
  • Evaluation of demographic characteristics and iNO administration (dosage, duration).

Main Results:

  • Elevated MetHb (>5%) was rare, occurring in only one term infant.
  • Higher maximum iNO dose was a significant risk factor for elevated MetHb.
  • High oxygen levels correlated with higher MetHb in term infants; preterm infants had no risk below 8 ppm iNO.

Conclusions:

  • High MetHb is exceptional in neonates receiving low-dose iNO.
  • Risk factors for elevated MetHb include high iNO dose and high oxygen concentrations.
  • Findings suggest potential to limit blood withdrawal during low-dose iNO therapy.

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