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Association Between Intermittent Hypoxemia or Bradycardia and Late Death or Disability in Extremely Preterm Infants.

JAMA·2015
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Early inhaled nitric oxide therapy for term and near-term newborn infants with hypoxic respiratory failure: neurodevelopmental follow-up.

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Ototoxic drugs and sensorineural hearing loss following severe neonatal respiratory failure.

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A randomized trial of early versus standard inhaled nitric oxide therapy in term and near-term newborn infants with hypoxic respiratory failure.

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Related Experiment Video

Updated: May 14, 2026

A Novel Inhalation Mask System to Deliver High Concentrations of Nitric Oxide Gas in Spontaneously Breathing Subjects
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Published on: May 4, 2021

Inhaled nitric oxide use in newborns.

Abraham Peliowski,

    Paediatrics & Child Health
    |February 2, 2013
    PubMed
    Summary

    Inhaled nitric oxide (iNO) improves oxygenation in newborns with persistent pulmonary hypertension. Evidence supports its use in infants over 35 weeks gestational age, with established safety protocols.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Pulmonology
    • Cardiovascular Physiology

    Background:

    • Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator crucial for regulating vascular tone.
    • Persistent pulmonary hypertension of the newborn (PPHN) involves high pulmonary vascular pressure and right-to-left shunting, leading to hypoxemic respiratory failure.
    • iNO has emerged as a therapeutic option for PPHN in neonates.

    Purpose of the Study:

    • To review the current evidence on the efficacy and safety of inhaled nitric oxide in neonatal respiratory failure.
    • To define the role of iNO in term and preterm infants with persistent pulmonary hypertension of the newborn.
    • To outline recommended dosing and administration protocols for iNO therapy.

    Main Methods:

    • Systematic review of existing clinical trials and observational studies.
    Keywords:
    NewbornNitric oxidePulmonary hypertensionRespiratory failure

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  • Analysis of data focusing on oxygenation, mortality, and need for advanced respiratory support (e.g., ECMO).
  • Evaluation of safety data, including adverse events and monitoring requirements in tertiary care settings.

    • Main Results:

    • Inhaled nitric oxide significantly improves oxygenation in neonates with PPHN.
    • For infants ≥35 weeks gestational age, iNO reduces the combined outcome of death or the need for extracorporeal membrane oxygenation (ECMO).
    • The efficacy and safety in preterm infants (<35 weeks gestational age) remain to be established.

    Conclusions:

    • iNO is a safe and effective treatment for PPHN in term and late preterm infants when administered with strict protocols in specialized centers.
    • The standard starting dose is 20 ppm, with a strategy for dose reduction as oxygenation improves.
    • Further research is needed to establish the role of iNO in extremely preterm infants.