Treatment of Persistent Pulmonary Hypertension of the Newborn with Nitric Oxide: A Randomized Trial † 1119
| Autor: | H. Farouk Sadiq |
|---|---|
| Rok vydání: | 1998 |
| Předmět: | |
| Zdroj: | Pediatric Research. 43:192-192 |
| ISSN: | 1530-0447 0031-3998 |
| DOI: | 10.1203/00006450-199804001-01140 |
| Popis: | Inhaled Nitric Oxide (iNO), a selective pulmonary vasodilator, is undergoing clinical trials as a therapy for persistent pulmonary hypertension of the newborn (PPHN). The Illinois Multicenter Nitric Oxide Trial is being conducted at 12 centers in the midwest with the hypothesis that iNO will improve oxygenation and reduce the need for ECMO. Patients with an Alveolar arterial oxygen gradient (AaDO2) 500-599 are randomized to receive either iNO(10-80ppm) or continue to receive standard medical therapy (SMT). The end-point for the randomization arm is an AaDO2 >599. At this AaDO2 SMT patients are eligible for rescue with iNO. So far 29 patients have been randomized- 16 to SMT and 13 to iNO. Arterial pO2 improved by a mean of 61±93 torr in the SMT group and by 241±96 torr in the iNO group within 6 hours of enrollment (p 600 and were rescued with iNO and of these 2 required ECMO. Only 8% (1/13) of the iNO group worsened to an AaDO2 >600 and eventually required ECMO, while the rest 92% showed significant improvement in oxygenation (p=0.014 for AaDO2>600 SMT vs iNO). Patients randomized to iNO tended to require fewer days of oxygen (15 vs 19) and a shorter hospital stay(18 vs 20) compared to those in the SMT group. We conclude that even in moderate PPHN iNO improves oxygenation. We speculate that if rescue with iNO had not been an available a significant proportion would have required ECMO. |
| Databáze: | OpenAIRE |
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