Inhaled nitric oxide in infants >1500 g and

Department of Pediatrics, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, United States
Journal of Perinatology (Impact Factor: 2.07). 07/2007; 27(6):347-52. DOI: 10.1038/
Source: PubMed


Inhaled nitric oxide (iNO) use in infants >1500 g, but <34 weeks gestation with severe respiratory failure will reduce the incidence of death and/or bronchopulmonary dysplasia (BPD).
Infants born at <34 weeks gestation with a birth weight >1500 g with respiratory failure were randomly assigned to receive placebo or iNO.
Twenty-nine infants were randomized. There were no differences in baseline characteristics, but the status at randomization showed a statistically significant difference in the use of high-frequency ventilation (P=0.03). After adjustment for oxygenation index entry strata, there was no difference in death and/or BPD (adjusted relative risk (RR) 0.80, 95% confidence interval (CI) 0.43 to 1.48; P=0.50), death (adjusted RR 1.26, 95% CI 0.47 to 3.41; P=0.65) or BPD (adjusted RR 0.40, 95% CI 0.47 to 3.41; P=0.21).
Although sample size limits our ability to make definitive conclusions, this small pilot trial of iNO use in premature infants >1500 g and <34 weeks with severe respiratory failure suggests that iNO does not affect the rate of BPD and/or death.

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Available from: Krisa P Vanmeurs, Dec 12, 2014
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    • "The rationale for the use of iNO in the prevention of BPD stems from animal and human studies supporting an anti-inflammatory role for NO and beneficial effects in lung structure and gas exchange [69–73]. Several large clinical trials with different study designs yielded variable results [74–79]. These studies included iNO given as prophylaxis to prevent BPD, as rescue therapy for severe acute respiratory failure, and as treatment for severe BPD in a variable patient population. "
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    International Journal of Pediatrics 01/2012; 2012(5):598606. DOI:10.1155/2012/598606
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    • "DSMBs terminated five RCTs and changed the protocol of one after an episode of toxicity [13]. Three RCTs were terminated due to the risk of toxicity [14–16], one was terminated for lack of efficacy [17] and another for administrative reasons [18] (Table 4). Four of these trials involved neonates. "
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    European Journal of Clinical Pharmacology 08/2011; 68(2):189-94. DOI:10.1007/s00228-011-1112-6 · 2.97 Impact Factor
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    ABSTRACT: Inhaled nitric oxide might help reduce breathing failure in preterm babies. Breathing failure in premature newborn babies can be complicated by lung hypertension (raised blood pressure in the lungs). Sedation, muscle relaxation or ventilation (mechanically assisted breathing) are used to treat lung hypertension. Nitric oxide is believed to help regulate muscle tone in the arteries of the lungs but it could also cause excessive bleeding (haemorrhage). The review of trials found nitric oxide therapy probably does not improve the chances of the baby having an improved outcome, but also probably did not have adverse effects on the developing lung, and did not increase bleeding.
    Cochrane database of systematic reviews (Online) 07/2007; 3(3):CD000509. DOI:10.1002/14651858.CD000509.pub3 · 6.03 Impact Factor
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