Outcome of neonates with persistent pulmonary hypertension of the newborn treated with inhaled nitric oxide.

OBJECTIVE

This study assessed the outcome of nitric oxide treatment in infants with persistent pulmonary hypertension of the newborn (PPHN) who failed high frequency oscillatory ventilation (HFOV).

METHOD

This study was conducted from July 1, 2000 to June 30, 2001 at the neonatal intensive care unit of Queen Sirikit National Institute of Child Health. Nitric oxide was administered to 20 infants, > or = 34 weeks gestational age who were diagnosed with PPHN and had two oxygenation index > or = 20 at least 30 minutes apart after HFOV treatment.

RESULTS

Nitric oxide inhalation significantly improved the oxygenation index, a/A ratio, A-a gradient (p<0.05) and directly measured partial pressure arterial oxygenation. Oxygen saturation improved within ten minutes after nitric oxide inhalation. The survival rate was 85 per cent. Meconium aspiration syndrome was the most common cause of PPHN. No acute complication was found during nitric oxide administration.

CONCLUSION

Inhalation of nitric oxide increased the blood oxygen tension of infants with PPHN without using a surfactant and ECMO. The authors suggest that inhalation nitric oxide is a useful adjunctive therapy for these patients.