Exhaled nitric oxide in neonates with or without hypoxemic respiratory failure

Tidal breath eNO measurements in a cohort of unsedated hospitalized neonates—A method validation

“…Olsen et al described higher V'NO in preterm infants with RDS compared with age‐matched infants without respiratory disorders, and explains it by more mature lungs and lower pulmonary vascular resistance in the healthy neonates. As described by Liu et al the timing of measurement is of importance as a part of the postnatal pulmonary adaptation. Newborns with hypoxic respiratory failure (HRF) up‐regulate their NO production within the first 2 days of life compared to non‐HRF newborns, presumably in response to proinflammatory cytokines .…”

“…Newborns with hypoxic respiratory failure (HRF) up‐regulate their NO production within the first 2 days of life compared to non‐HRF newborns, presumably in response to proinflammatory cytokines . The ventilation‐perfusion mismatch and intrapulmonary shunting seen in various respiratory disorders in human and baboon infants may stimulate NO production by iNOS . Thus, eNO may reflect lung maturation and be an early biomarker for acute or long‐term pulmonary morbidity.…”

“…Despite many years of research, the mechanisms of elevated infant and neonatal eNO are still poorly understood, and results are conflicting, as values change with postnatal age and respiratory morbidity . An up‐regulation of inducible Nitric Oxide Synthase (iNOS) can be initiated by proinflammatory cytokines and exogenous factors like bacterial toxins in macrophages and other cells .…”

“…Despite many years of research, the mechanisms of elevated infant and neonatal eNO are still poorly understood, and results are conflicting, as values change with postnatal age and respiratory morbidity. [1][2][3][4][5][6] An up-regulation of inducible Nitric Oxide Synthase (iNOS) can be initiated by proinflammatory cytokines and exogenous factors like bacterial toxins in macrophages and other cells. 2,7,8 Exhaled NO is used as an indirect biomarker of eosinophil inflammation and expected responsiveness to steroids in asthma patients, 7,9,10 but high eNO levels were also recognized in the absence of eosinophils.…”

Exhaled nitric oxide is associated with postnatal adaptation to hypoxia in Tibetan and non‐Tibetan newborn infants

“…Our previous study on intra‐tracheally ventilated preterm and term neonates with hypoxemic respiratory failure showed that the average value of FeNO from the lower airway was 8–9 ppb after we excluded the NO that originated from the upper airway. This was as opposed to 7–8 ppb in spontaneously breathing controls, when the NO from the upper airway was not excluded in the first week of life .…”