Document Detail

Inhaled nitric oxide and methemoglobin in full-term infants with persistent pulmonary hypertension of the newborn.
MedLine Citation:
PMID:  11969358     Owner:  NLM     Status:  MEDLINE    
Inhaled nitric oxide (iNO), a potent pulmonary vasodilator, has become a mainstay therapy for neonates with persistent pulmonary hypertension of the newborn (PPHN). However, it also oxidizes hemoglobin to methemoglobin (metHgb), thereby reducing the delivery of oxygen to tissues. Studies have suggested that elevated levels of metHgb may be avoided by limiting iNO concentration to less than 40 parts per million (ppm). However, the relationship between iNO exposure and elevated levels of metHgb (greater than 4%) has not been examined. Therefore, we studied this relationship in full term newborns with PPHN. We reviewed the charts of twenty-eight neonates with a diagnosis of PPHN admitted to our Intensive Care Nursery between 1/92 and 10/97. Our retrospective analysis demonstrated that: (1) high metHgb levels can occur with exposure to low iNO concentration (three of eight newborns with maximum metHgb levels >4% had been exposed to no more than 40 ppm of iNO concentration); and (2) cumulative iNO ( summation operatoriNO) exposure was the best predictor of elevated metHgb levels (seven of nine newborns receiving summation operatoriNO>2000 ppm x hour had maximum metHgb levels >4%).
Karla L Salguero; James J Cummings
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Pulmonary pharmacology & therapeutics     Volume:  15     ISSN:  1094-5539     ISO Abbreviation:  Pulm Pharmacol Ther     Publication Date:  2002  
Date Detail:
Created Date:  2002-04-23     Completed Date:  2002-07-12     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  9715279     Medline TA:  Pulm Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  1-5     Citation Subset:  IM    
Copyright Information:
Copyright 2002 Elsevier Science Ltd.
Department of Physiology and BioPhysics, Center for the Developmental Biology of the Lung, State University of New York at Buffalo, 14214, USA.
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MeSH Terms
Administration, Inhalation
Extracorporeal Membrane Oxygenation
Hypertension, Pulmonary / drug therapy*
Infant, Newborn
Intensive Care, Neonatal / methods
Methemoglobin / drug effects*,  metabolism
Nitric Oxide / administration & dosage,  adverse effects,  therapeutic use*
Reg. No./Substance:
10102-43-9/Nitric Oxide; 9008-37-1/Methemoglobin

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

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