Document Detail

Inhaled nitric oxide improves oxygenation in very premature infants with low pulmonary blood flow.
MedLine Citation:
PMID:  14989442     Owner:  NLM     Status:  MEDLINE    
AIM: Inhaled nitric oxide (iNO) is used to reduce right-to-left extrapulmonary shunting by decreasing pulmonary vascular resistance in term or near-term infants. The objectives of this study were to determine, first, the pulmonary blood flow status of very preterm infants with hypoxaemic respiratory failure, then the response of oxygenation to iNO therapy according to pulmonary blood flow (PBF) and, finally, to verify the lack of adverse side effects of iNO on the ductus arteriosus. METHODS: Infants below 32 wk gestational age (GA) with hypoxic respiratory failure and aAO2 < 0.22 were randomized as the control or iNO group. PBF was evaluated by pulsed Doppler measurement of mean pulmonary blood flow velocity (MPBFV) in the left pulmonary artery. Low PBF (LPBF) was defined as MPBFV < 0.2 m/s. RESULTS: Seventy infants of 23 to 31 wk GA with hypoxic respiratory failure were randomized either to receive or not to receive 5 ppm iNO in addition to optimal care. Twenty-eight infants were diagnosed with LPBF (11/35 in iNO vs 17/35 in the control groups). Thirty minutes after receiving iNO the number of LPBF infants dropped to 8/35. In the iNO group, aAO2 increased significantly from 0.14 +/- 0.05 to 0.24 +/- 0.08 after iNO, but only in the LPBF infants (mean +/- SD; p = 0.027). CONCLUSION: In infants below 32 wk GA with hypoxic respiratory failure, Doppler echocardiographic assessment of LPBF seems to be able to determine which patients are likely to benefit from iNO therapy on systemic oxygenation.
R Desandes; E Desandes; P Droullé; F Didier; D Longrois; J M Hascoët
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  93     ISSN:  0803-5253     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-03-01     Completed Date:  2004-05-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  66-9     Citation Subset:  IM    
Department of Neonatology, Maternite Regionale Universitaire, Nancy, France.
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MeSH Terms
Administration, Inhalation
Blood Pressure / drug effects
Heart Rate / drug effects
Infant, Newborn
Infant, Premature*
Nitric Oxide / administration & dosage,  therapeutic use*
Pulmonary Circulation / drug effects*
ROC Curve
Respiratory Distress Syndrome, Newborn / drug therapy*
Reg. No./Substance:
10102-43-9/Nitric Oxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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