Inhaled Nitric Oxide in the Treatment of Moderate Persistent Pulmonary Hypertension of the Newborn: A Randomized Controlled, Multicenter Trial

Sadiq, Heena; Mantych, Gregory J.; Benawra, Raghbir; Devaskar, Uday; Hocker, James R.

doi:10.1038/sj.jp.7210878

Cited by 38 publications

(19 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Franco-Belgium Collaborative NO Trial Group 17 showed a decrease in length of mechanical ventilation and a lower proportion of infants requiring oxygen at 28 days when iNO was used in near-term infants younger than 7 days with moderate respiratory failure (OI of 15 to 40). Sadiq et al 18 compared iNO treatment with standard treatment in near-term infants with moderate PPHN (alveolar-arterial oxygen gradient, (AaDO 2 ) of 500 to 599 torr), they found that iNO treatment improved PaO 2 , reduced the amount of ventilatory support and prevented progression to severe PPHN defined as AaDO 2 > 600 torr. Infants of the Control group also received iNO if their AaDO 2 was >600, there were no differences in need for ECMO or incidence of death.…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled trial of early compared with delayed use of inhaled nitric oxide in newborns with a moderate respiratory failure and pulmonary hypertension

et al. 2009

View full text Add to dashboard Cite

Objective: To evaluate whether early treatment with inhaled nitric oxide (iNO) will prevent newborns with moderate respiratory failure from developing severe hypoxemic respiratory failure (oxygenation index (OI)X40).Study Design: A total of 56 newborns with moderate respiratory failure (OI between 10 and 30) were randomized before 48 h after birth to early treatment with 20 p.p.m. of iNO (Early iNO group, n ¼ 28) or conventional mechanical ventilation with FiO 2 1.0 (Control group, n ¼ 28). Infants received iNO and/or high-frequency oscillatory ventilation (HFOV) if they developed an OI>40.Result: 7 of 28 early iNO patients (25%) compared to 17 of 28 control patients (61%) developed an OI>40 (P<0.05). In the Early iNO group mean OI significantly decreased from 22 (baseline) to 19 at 4 h (P<0.05) and remained lower over time: 19 (12 h), 18 (24 h) and 16 at 48 h. In contrast, OI increased in the Control group and remained significantly higher than the Early iNO group during the first 48 h of study: 22 (baseline), 29, 35, 32 and 23 at 4, 12, 24 and 48 h, respectively (P<0.01). Of 17, 6 control patients who developed an OI>40 were successfully treated with iNO. Nine of the remaining eleven control patients and six of seven Early iNO patients who had an OI>40 despite use of iNO responded with the addition of HFOV. One patient of the Early iNO group and two of the Control group died. Median (range) duration of oxygen therapy was significantly shorter in the Early iNO group: 11.5 (5 to 90) days compared to 18 (6 to 142) days of the Control group (P<0.03).Conclusion: Early use of iNO in newborns with moderate respiratory failure improves oxygenation and decreases the probability of developing severe hypoxemic respiratory failure.

show abstract

Section: Discussionmentioning

confidence: 99%

Randomized controlled trial of early compared with delayed use of inhaled nitric oxide in newborns with a moderate respiratory failure and pulmonary hypertension

et al. 2009

View full text Add to dashboard Cite

show abstract

“…For this condition, inhaled nitric oxide (iNO) and extracorporeal membrane oxygenation (ECMO) have been recognized as effective therapies and can significantly improve survival and reduce morbidity [2,3]. ECMO, however, is a very invasive therapy and can only be administered in limited institutions.…”

Section: Introductionmentioning

confidence: 99%

Combination Drug Therapy for Persistent Pulmonary Hypertension of the Newborn

Yokoo¹,

Marumo²,

Nishida³

et al. 2017

Health Edu Care

View full text Add to dashboard Cite

“…In some of the studies, infants in the control group were allowed to be treated with iNO if they met predefined criteria for persistent respiratory failure. 11,12,13,19,20,23,24 This is a critical issue in the interpretation of these trials and in the meta-analysis. Although ethically responsible, the treatment of the control group with iNO makes interpretation of the data problematic.…”

Section: Introductionmentioning

confidence: 99%

“…The majority of the studies required echocardiographic evidence of PPHN. 12,13,15,16,18,19,22,23 Inhaled nitric oxide was given in a 'masked' or 'unmasked' manner. In some of the studies, infants in the control group were allowed to be treated with iNO if they met predefined criteria for persistent respiratory failure.…”

Section: Introductionmentioning

confidence: 99%