In this study there was no evidence of a significant effect on either survival or long-term neurodevelopmental status in infants treated with iNO.

Case reportsPatient 1 A 3.3 kg female infant was an extended breech presentation at term. She was born by lower segment caesarean section after labour had failed to progress. There was no difficulty during delivery and the infant's Apgar scores were 9 and 10 at 1 and 5 min, respectively. Examination of the infant on day 1 was normal but on day 6 her mother noticed a tender left leg. The left knee was swollen, tender and movement was limited. The baby was clinically well with a normal temperature. X-ray showed elevation of the periosteum of the distal femur and antibiotic therapy was started on a presumptive diagnosis of septic arthritis. The baby remained apyrexial. Blood cultures were sterile and white cell count and erythrocyte sedimentation rate were normal. Repeat X-rays showed callus formation at the distal end of the left femur, associated with metaphyseal fractures of the femur and upper tibia. Skeletal survey was otherwise normal. Antibiotic therapy was stopped and the baby was discharged. When reviewed 2 weeks later, the swelling and tenderness of the knee had subsided. Patient 2A female infant was born at 40 weeks gestation weighing 4.14 kg. Delivery was by elective lower segment caesarean section for flexed breech presentation in a primigravida. The baby was delivered without any difficulty and cried at birth. Apgar scores were 9 at 1 and 5 min. Routine examination on day 1 was unremarkable. On day 2, the baby was noted to have aswollen right knee but was otherwise well. The knee was warm and tender but there was full movement of the joint. Antibiotics were given and continued until blood Mill Road Maternity Hospital

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Inhaled nitric oxide (iNO) is used to treat preterm infants with hypoxaemic respiratory failure. In this study we describe the long‐term survival and neurodevelopmental status of high‐risk preterm infants enrolled into a randomized controlled trial of iNO therapy. Information regarding long‐term outcome was available for all 25 children enrolled in the original trial who survived until discharge from hospital. Formal, blinded, developmental assessment and neurological examinations were performed in 21 out of 22 children still alive at 30 mo of age, corrected for prematurity. No significant differences were found in long‐term mortality (12/20 vs 8/22, RR 1.65,95% CI 0.87–3.3), neurodevelopmental delay (4/7 vs 9/14, RR 0.89,95% CI 0.37–1.75), severe neurodisability (0/7 vs 5/14, p= 0.12) or cerebral palsy (0/7 vs 2/14, p= 0.53) between iNO‐treated and control infants. Conclusion: In this study there was no evidence of a significant effect on either survival or long‐term neurodevelopmental status in infants treated with iNO.

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