Clinical responses to prolonged treatment of persistent pulmonary hypertension of the newborn with low doses of inhaled nitric oxide

Kinsella, John P.; Neish, Steven R.; Ivy, D. Dunbar; Shaffer, Elizabeth; Abman, Steven H.

doi:10.1016/s0022-3476(05)81551-3

Cited by 311 publications

(115 citation statements)

References 20 publications

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“…44 The current experience with iNO therapy, however, suggests that there is no loss of drug effect even after prolonged treatment, 45,46 on the contrary, iNO concentrations can be reduced in the course of treatment without losing effectiveness. 46,47 In our study, iNOinduced neuroprotection could not be improved by intermittent application of the therapy, suggesting that-as evidenced by other groups-tachyphylaxy does not occur during NO inhalation therapy.…”

Section: Discussionsupporting

confidence: 41%

Inhaled Nitric Oxide Reduces Secondary Brain Damage after Traumatic Brain Injury in Mice

Terpolilli¹,

Kim²,

Thal³

et al. 2012

J Cereb Blood Flow Metab

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Ischemia, especially pericontusional ischemia, is one of the leading causes of secondary brain damage after traumatic brain injury (TBI). So far efforts to improve cerebral blood flow (CBF) after TBI were not successful because of various reasons. We previously showed that nitric oxide (NO) applied by inhalation after experimental ischemic stroke is transported to the brain and induces vasodilatation in hypoxic brain regions, thus improving regional ischemia, thereby improving brain damage and neurological outcome. As regional ischemia in the traumatic penumbra is a key mechanism determining secondary posttraumatic brain damage, the aim of the current study was to evaluate the effect of NO inhalation after experimental TBI. NO inhalation significantly improved CBF and reduced intracranial pressure after TBI in male C57 Bl/6 mice. Long-term application (24 hours NO inhalation) resulted in reduced lesion volume, reduced brain edema formation and less blood-brain barrier disruption, as well as improved neurological function. No adverse effects, e.g., on cerebral auto-regulation, systemic blood pressure, or oxidative damage were observed. NO inhalation might therefore be a safe and effective treatment option for TBI patients.

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Section: Discussionsupporting

confidence: 41%

Inhaled Nitric Oxide Reduces Secondary Brain Damage after Traumatic Brain Injury in Mice

Terpolilli¹,

Kim²,

Thal³

et al. 2012

J Cereb Blood Flow Metab

View full text Add to dashboard Cite

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“…There were no systemic side effects, and methemoglobin levels remained stable. Kinsella et al showed the same result with lesser amounts of 10 to 20 ppm in 7 term neonates (17) . The improvement was sustained with NO 6 ppm for 24 hours.…”

Section: Discussionmentioning

confidence: 68%

Nitric Oxide Use in Neonatal and Adult Patients at Baylor University Medical Center

Perelmuter¹,

Whitfield²,

Ramsay³

et al. 1996

Baylor University Medical Center Proceedings

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“…One of the more intriguing discoveries in recent years was that iNO, acting as a selective pulmonary vasodilator, could produce marked benefit in neonates with PPHN (117,118). The early reports used considerably higher concentrations than those generally used today.…”

Section: Cardiopulmonary Supportmentioning

confidence: 99%

The Evolution of Neonatology

Philip

2005

Pediatr Res

544

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In 1960, the terms "neonatology" and "neonatologist" were introduced. Thereafter, an increasing number of pediatricians devoted themselves to full-time neonatology. In 1975, the first examination of the Sub-Board of Neonatal-Perinatal Medicine of the American Board of Pediatrics and the first meeting of the Perinatal Section of the American Academy of Pediatrics were held. One of the most important factors that improved the care of the neonate was the miniaturization of blood samples needed to determine blood gases, serum electrolytes, glucose, calcium, bilirubin, and other biochemical measurements. Another factor was the ability to provide nutrition intravenously, and the third was the maintenance of normal body temperature. The management of respiratory distress syndrome improved with i.v. glucose and correction of metabolic acidosis, followed by assisted ventilation, continuous positive airway pressure, antenatal corticosteroid administration, and the introduction of exogenous surfactant. Pharmacologic manipulation of the ductus arteriosus, support of blood pressure, echocardiography, and changes in the management of persistent pulmonary hypertension, including the use of nitric oxide and extracorporeal membrane oxygenation, all have influenced the cardiopulmonary management of the neonate. Regionalization of neonatal care; changes in parent-infant interaction; and technological changes such as phototherapy, oxygen saturation monitors, and brain imaging techniques are among the important advances reviewed in this report. Most remarkable, a 1-kg infant who was born in 1960 had a mortality risk of 95% but had a 95% probability of survival by 2000. However, errors in neonatology are acknowledged, and potential directions for the future are explored. Abbreviations AAP, American Academy of Pediatrics BPD, bronchopulmonary dysplasia CPAP, continuous positive airway pressure ECMO, extracorporeal membrane oxygenation ELBW, extremely low birth weight HMD, hyaline membrane disease iNO, inhaled nitric oxide IUGR, intrauterine growth restriction IVH, intraventricular hemorrhage L/S, ratio of lecithin, phosphatidyl choline, to sphingomyelin NICU, neonatal intensive care unit PDA, patent ductus arteriosus PEEP, positive end expiratory pressure PPHN, persistent pulmonary hypertension of the newborn PVH, periventricular hemorrhage RDS, respiratory distress syndrome ROP, retinopathy of prematurity SIDS, sudden infant death syndrome VLBW, very low birth weight VON, Vermont-Oxford Network "There is need for specialization in neonatal medicine. This applies to doctors and nurses as well as teaching and construction of hospitals. The specialist in neonatal diseases and the nurse intensively trained and expert in the management of delicate newborns will be commonplace ere long." J.W. Ballantyne, 1923 (1) "In previous times the problems of the newborn child have been the province of the obstetrician, a field in which he has taken comparatively little interest and to which he has contributed little. As pediatricians we have but s...

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Clinical responses to prolonged treatment of persistent pulmonary hypertension of the newborn with low doses of inhaled nitric oxide

Cited by 311 publications

References 20 publications

Inhaled Nitric Oxide Reduces Secondary Brain Damage after Traumatic Brain Injury in Mice

Inhaled Nitric Oxide Reduces Secondary Brain Damage after Traumatic Brain Injury in Mice

Nitric Oxide Use in Neonatal and Adult Patients at Baylor University Medical Center

The Evolution of Neonatology

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