Nitric oxide in the management of persistent pulmonary hypertension of the newborn—an unusual cause of failure

Dc, Jerwood; Ma, Stokes

doi:10.1111/j.1460-9592.1995.tb00277.x

Cited by 3 publications

(5 citation statements)

References 6 publications

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“…Since then there have been six additional reports of neonatal PAVMs. 3,4,[6][7][8][9] As in this case, the most pronounced feature of neonatal presentations is cyanosis that is unresponsive to supplemental oxygen and mechanical ventilation. Other respiratory symptoms include tachypnea and respiratory distress.…”

Section: Discussionmentioning

confidence: 69%

Giant Neonatal Pulmonary Arteriovenous Malformation: An Imaging and Management Challenge

Lin

Hogan

Stillwell

et al. 2020

CASE

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Section: Discussionmentioning

confidence: 69%

Giant Neonatal Pulmonary Arteriovenous Malformation: An Imaging and Management Challenge

Lin

Hogan

Stillwell

et al. 2020

CASE

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“…They found spontaneous regression in the size of the feeder vessel as well as in the size of vascular bed of the congenital hepatic AVM with conservative use of oral heart failure therapy with diuretic agents and captopril observed a decrease in the congestion and diameter of the affected vessels. Although we do not have any pulmonary AVMs in our study population, Jerwood DC et al reported a case of pulmonary AVM in which right-to-left shunting still occurred regardless of the therapy used [13]. Upon reassessment a substantial pulmonary AVM was found, a surgery was performed during the neonatal period which turnout to be successful.…”

Section: Discussionmentioning

confidence: 75%

“…However, its use in infants with increased pulmonary blood ow (PBF) remains questionable as it can worsen the symptoms of congestive heart failure (CHF). Jerwood and Stokes reported a case of PH, where a massive pulmonary AVM was found to be the underlying cause of reassessment [13]. Hendson et al reported using iNO to decrease pulmonary pressures in the case of cerebral AVMs.…”

Section: Introductionmentioning

confidence: 99%

Effects of inhaled nitric oxide (iNO) in pulmonary hypertension secondary to arteriovenous malformations: a retrospective cohort study from the European iNO Registry

Chakkarapani

Gupta

Jamil

et al. 2022

Preprint

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Purpose: To assess the effect of inhaled nitric oxide (iNO) on oxygenation in the management of pulmonary hypertension (PH) secondary to arteriovenous malformations (AVMs) in neonates.Method: A matched retrospective cohort study from January 1, 2013, to December 31, 2017. European inhaled nitric oxide registry from 43 neonatal and pediatric ICUs in 13 countries across Europe was used to extract data. The target population was neonates treated with iNO for the management of PH. The cases (PH secondary to AVMs treated with iNO) were matched (1:4 ratio) to controls (PH without AVMs treated with iNO). The main outcome measure was the absolute change of oxygenation index (OI) from baseline to 60 minutes after starting iNO in cases and control.Results: A total of 45 infants out of 1830 (9 cases and 36 controls) were identified, who received inhaled nitric oxide during ICU stay. The mean baseline value of OI (%) (cases: 27.5, controls: 34), the mean value of OI (%) after 60 minutes of iNO use (cases: 16.8, controls: 28.5), and the mean absolute change in OI value (%) from baseline to 60 minutes of iNO (cases: 10.7 and controls: 6) was not statistically different between groups.Conclusion: Infants with PH secondary to AVMs treated with iNO did not respond differently compared to babies presented with PH without AVMs treated with iNO. Right ventricle dysfunction on echocardiography was higher in cases (cases: 66.7% and controls: 28.6%) but not statistically significant. The death rate before discharge was significantly higher among cases (cases: 55.6% and controls: 8.3%).

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“…They observed a decrease in the congestion and diameter of the affected vessels. Although we do not have any pulmonary AVMs in our study population, Jerwood DC et al reported a case of pulmonary AVM in which right-to-left shunting still occurred regardless of the therapy used [ 13 ]. Upon reassessment, substantial pulmonary AVM was found, and surgery was performed during the neonatal period, which turned out to be successful.…”

Section: Discussionmentioning

confidence: 86%

“…However, its use in infants with increased pulmonary blood flow (PBF) remains questionable as it can worsen the symptoms of congestive heart failure (CHF). Jerwood and Stokes reported a case of PH, where a massive pulmonary AVM was found to be the underlying cause of reassessment [ 13 ]. Hendson et al reported using iNO to decrease pulmonary pressures in the case of cerebral AVMs.…”

Section: Introductionmentioning

confidence: 99%

Effects of inhaled nitric oxide (iNO) in pulmonary hypertension secondary to arteriovenous malformations: a retrospective cohort study from the European iNO registry

et al. 2022

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This study aims to assess the effects of inhaled nitric oxide (iNO) on oxygenation in the management of pulmonary hypertension (PH) secondary to arteriovenous malformations (AVMs) in neonates. This is a matched retrospective cohort study from January 1, 2013, to December 31, 2017. The European inhaled nitric oxide registry from 43 neonatal and pediatric ICUs in 13 countries across Europe was used to extract data. The target population was neonates treated with iNO for the management of PH. The cases (PH secondary to AVMs treated with iNO) were matched (1:4 ratio) to controls (PH without AVMs treated with iNO). The main outcome measure was the absolute change of oxygenation index (OI) from baseline to 60 min after starting iNO in cases and controls. The primary outcome of our study was that the mean absolute change in OI from baseline to after 60 min was higher among cases 10.7 (14), than in controls 6 (22.5), and was not statistically different between the groups. The secondary outcome variable — death before discharge — was found to be significantly higher in cases (55%) than in controls (8%). All the other variables for secondary outcome measures remained statistically insignificant. Conclusion: Infants with PH secondary to AVMs treated with iNO did not respond differently compared to those presented with PH without AVMs treated with iNO. Right ventricular dysfunction on echocardiography was higher in cases than controls (cases: 66.7% and controls: 28.6%) but was not statistically significant. What is Known:• Arterioenous malformation (AVM) is a well-known cause of persistent pulmonary hypertension in newborns. Inhaled nitric oxide (iNO) is most commonly used as first-line therapy for pulmonary hypertension in newborns.• Around 40–50% of vein of Galen malformations (VOGMs) are found to have congestive heart failure in the neonatal period. What is New:• Neonates may present with an isolated PH of the newborn as the main feature of the VOGMs. A large proportion of cases with AVMs have been associated with right ventricular cardiac dysfunction. • Results from one of the largest database registries in the world for iNO have been used to answer our research question.

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Nitric oxide in the management of persistent pulmonary hypertension of the newborn—an unusual cause of failure

Cited by 3 publications

References 6 publications

Giant Neonatal Pulmonary Arteriovenous Malformation: An Imaging and Management Challenge

Giant Neonatal Pulmonary Arteriovenous Malformation: An Imaging and Management Challenge

Effects of inhaled nitric oxide (iNO) in pulmonary hypertension secondary to arteriovenous malformations: a retrospective cohort study from the European iNO Registry

Effects of inhaled nitric oxide (iNO) in pulmonary hypertension secondary to arteriovenous malformations: a retrospective cohort study from the European iNO registry

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