Document Detail

Nitric oxide inhalation therapy in very low-birthweight infants with hypoplastic lung due to oligohydramnios.
MedLine Citation:
PMID:  15043657     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although nitric oxide inhalation (iNO) therapy improves arterial oxygenation and reduces the rate of extracorporeal membrane oxygenation in term neonates, the efficacy of this therapy in premature infants is controversial. The objective of the present study was to determine whether iNO therapy improves the survival of very low-birthweight infants with pulmonary hypoplasia due to prolonged rupture of membrane. METHODS: A retrospective comparative study of very low-birthweight infants with pulmonary hypoplasia due to oligohydramnios who had or had not been treated with iNO therapy, was performed (iNO-treated group, eight infants; control group, 10 infants). A neonate was considered to have pulmonary hypoplasia due to oligohydramnios if the following conditions were satisfied: (i) artificial surfactant treatment did not improve the respiratory distress; (ii) prolonged rupture of membrane (PROM) continued for more than 5 days with oligohydramnios; and (iii) sufficient arterial oxygenation did not occur even after giving 100% oxygen, and more than 8 cm H(2)O of mean airway pressure was needed to maintain arterial oxygenation. RESULTS: Nitric oxide inhalation improved arterial oxygenation rapidly and consistently in all eight infants with pulmonary hypoplasia. All eight iNO-treated infants survived longer than 28 days, while five of the 10 control infants died within 24 h of birth (P < 0.05). Before starting iNO, seven of the eight treated infants had shown persistent pulmonary hypertension, which was confirmed by echocardiography. No iNO-treated infant had IVH greater than grade 1, while one control infant had grade 2 IVH. All six long-term survivors in the iNO-treated group are developing normally, while only two of the control infants are developing normally as of February 2002. CONCLUSIONS: The majority of the infants with pulmonary hypoplasia due to oligohydramnios had persistent pulmonary hypertension. iNO improved the arterial oxygenation and significantly improved the survival rate. A controlled study to determine whether iNO therapy improves the survival rate of preterm infants with pulmonary hypoplasia due to oligohydramnios is necessary.
Naoki Uga; Tetsuya Ishii; Yasuhiro Kawase; Hiroko Arai; Hiroshi Tada
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pediatrics international : official journal of the Japan Pediatric Society     Volume:  46     ISSN:  1328-8067     ISO Abbreviation:  Pediatr Int     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-03-26     Completed Date:  2004-04-21     Revised Date:  2008-05-21    
Medline Journal Info:
Nlm Unique ID:  100886002     Medline TA:  Pediatr Int     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  10-4     Citation Subset:  IM    
Division of Neonatology, Perinatal Center, Toho University School of Medicine, Tokyo, Japan.
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MeSH Terms
Administration, Inhalation
Asphyxia Neonatorum / etiology,  mortality,  therapy*
Bronchodilator Agents / therapeutic use*
Infant, Newborn
Infant, Very Low Birth Weight*
Japan / epidemiology
Lung / abnormalities*
Nitric Oxide / therapeutic use*
Oligohydramnios / complications
Retrospective Studies
Survival Rate
Treatment Outcome
Reg. No./Substance:
0/Bronchodilator Agents; 10102-43-9/Nitric Oxide

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