Document Detail


Methemoglobin to cumulative nitric oxide ratio and response to inhaled nitric oxide in PPHN.
MedLine Citation:
PMID:  19554014     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: One-third of infants with persistent pulmonary hypertension of the newborn (PPHN) do not respond to inhaled nitric oxide (iNO). If iNO is not delivered to the pulmonary vasculature because of parenchymal lung disease, it cannot interact with hemoglobin to form methemoglobin (MHb). OBJECTIVE: To study the correlation between oxygenation response to iNO in infants with PPHN secondary to parenchymal lung disease and initial MHb% to cumulative NO exposure (ppm x hours) ratio (MHb/SigmaNO). STUDY DESIGN: Retrospective chart review of neonates with PPHN secondary to parenchymal lung disease treated with iNO comparing non-responders (PaO(2)/FiO(2) ratio<10 change with iNO) with responders (>or=10 change). RESULT: Non-responders (n=16) had a PaO(2)/F(iO2) of 83+/-48 (mean+/-s.d.) and decreased to 74+/-44 after iNO. PaO(2)/FiO(2) increased from 70+/-48 to 151+/-63 with iNO among responders (n=36). The MHb/SigmaNO ratio was low (0.024+/-0.012) among non-responders compared with responders (0.07+/-0.053, P<0.005). CONCLUSION: Inadequate oxygenation response to iNO is associated with lower MHb/SigmaNO, suggesting suboptimal delivery of iNO to the pulmonary vasculature.
Authors:
M J Pabalan; S P Nayak; R M Ryan; V H Kumar; S Lakshminrusimha
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-06-25
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  29     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-28     Completed Date:  2010-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  698-701     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Division of Neonatology, University at Buffalo, Women and Children's Hospital of Buffalo, Buffalo, NY 14222, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Blood Gas Analysis
Case-Control Studies
Dose-Response Relationship, Drug
Drug Monitoring
Humans
Infant, Newborn
Meconium Aspiration Syndrome / complications
Methemoglobin / analysis*,  metabolism
Nitric Oxide / administration & dosage*,  blood*
Persistent Fetal Circulation Syndrome / complications,  drug therapy*
Pneumonia, Aspiration / complications
Respiratory Distress Syndrome, Newborn / complications
Retrospective Studies
Treatment Failure
Vasodilator Agents / administration & dosage*,  blood*
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 10102-43-9/Nitric Oxide; 9008-37-1/Methemoglobin

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