Endotracheal inhalatory sodium nitroprusside in severely hypoxic newborns

This study examined the response of 10 newborns admitted to the Neonatal Intensive Care Unit of Hospital Universitário, UFMS, Campo Grande, MS, Brazil, submitted to mechanical ventilation under the following ventilator parameters: FiO2 = 100%, PIP (24 mmHg, rate > 30 mpm. All had severe hypoxia and were treated with a solution of sodium nitroprusside (SNP) administered through a special adapter for continuous endotracheal inhalation. Significant increases in PaO2, SaO2 and in PaO2/FiO2 ratio were observed at 1 h and at 6-8 h of treatment, whereas blood pressure did not change significantly while treatment was being delivered. No side effects such as methemoglobinemia or cyanogen accumulation were observed. Although appropriate studies using animal models have still to be conducted, present results suggest that endotracheal inhalation of SNP could constitute a valid form of treatment for newborns with persistent pulmonary hypertension or severe hypoxia of difficult management.