Nitric oxide inhalation in infants with respiratory distress syndrome

• Published in: The Journal of pediatrics Vol. 130; no. 2; pp. 225 - 230
• Main Authors: Skimming, Jeffrey W., Bender, Kelley A., Hutchison, Alastair A., Drummond, Willa H.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-02-1997; Elsevier
• Subjects: Administration, Inhalation; Analysis of Variance; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Combined Modality Therapy; Dose-Response Relationship, Drug; Emergency and intensive respiratory care; Humans; Infant, Newborn; Infant, Premature; Intensive care medicine; Medical sciences; Nitric Oxide - administration & dosage; Oxygen Inhalation Therapy; Prospective Studies; Respiration, Artificial; Respiratory Distress Syndrome, Newborn - blood; Respiratory Distress Syndrome, Newborn - drug therapy; Respiratory System Agents - administration & dosage; Treatment Outcome; RDS; Pa o 2; Sp o 2; sRR; Sa o 2; Pa co 2; Premature; Respiratory disease; Indication; Nitric oxide; Treatment efficiency; Respiratory distress; Oxygenation; Therapeutic protocol; Inhalation
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(97)70347-0

Objective: This study was designed to test the hypothesis that nitric oxide inhalation increases systemic arterial blood oxygen tension of prematurely delivered infants with respiratory distress syndrome.
Methods: Nitric oxide was administered to 23 preterm infants with a diagnosis of respiratory distress syndrome. The infants were randomly assigned to receive either 5 or 20 ppm of nitric oxide and were studied between 24 and 168 hours after delivery. The treatment period for each infant lasted 15 minutes and was preceded by and followed by a 15-minute control period. We evaluated all outcome variables by using two-way repeated measures analysis of variance;
p values less than 0.01 were considered significant.
Results: Nitric oxide inhalation caused significant increases in the following: arterial blood oxygen tension, directly measured arterial oxyhemoglobin saturation, and transcutaneously measured arterial oxyhemoglobin saturation. No differences between the effects of the two nitric oxide concentrations were detected, nor were residual effects detected 15 minutes after either dose of nitric oxide was discontinued.
Conclusions: Inhalation of both 5 and 20 ppm nitric oxide causes concentration-independent increases in the blood oxygen tensions of preterm infants with respiratory distress syndrome. We speculate that nitric oxide inhalation may be a useful adjunctive therapy for these patients. (J Pediatr 1997;130:225-30)