Background:This study was designed to evaluate the effect of nitric oxide
(NO) on the management of neonates with severe persistent pulmonary
hypertension refractory to high-frequency oscillatory ventilation.Methods:The birth weight and the gestational age of infants
were 3125.5 ± 794 g (mean ± SD) and 39 ± 2.4 weeks, respectively. All
neonates were ventilated for an average of 137.5 min (range 90-180 min) prior to
NO therapy. The mean oxygenation index (OI) of all neonates prior to NO was
46.3 ± 5 (mean ± SEM). NO was initially administered at 20 parts per
million (ppm) for at least 2 h and increased gradually by 2 ppm to a maximum of
80 ppm.Results:Eighteen infants (75%) responded and six (25%) did not respond to
the treatment. Three neonates died in the responding group, while all the
non-responders died (P = 0.0001). The survival rate was 62.5% among all
neonates. NO significantly decreased OI (P < 0.0001) and improved
the arterial/alveolar (a/A) oxygen ratio (P < 0.0001) within the
first 2 h of NO therapy in 61.1% of the responders. However, the OI and the a/A
oxygen ratio remained almost the same throughout the treatment in the
non-responders and the non-survivors.Conclusion:Inhaled NO at 20 ppm, following adequate ventilation for 2 h without
significant response, could be used to identify the majority of the
non-responders in order to seek other alternatives.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.