Controversies in neonatology: The efficacy of inhaled nitric oxide in preterm infants with persistent pulmonary hypertension

Authors : Gonca VARDAR, Meliha AKSOY OKAN, Sevilay TOPÇUOĞLU, Nilgün KARADAĞ, Elif ÖZALKAYA, Hande OZGUN KARATEPE, Güner KARATEKİN

Pages : 1303-1311

Doi:10.32322/jhsm.1104799

View : 29 | Download : 10

Publication Date : 2022-09-25

Article Type : Research Paper

Abstract :Introduction: There is limited and conflicting information in literature regarding use of inhaled nitric oxide insert ignore into journalissuearticles values(iNO); in preterm infants. In this study we examined the characteristics of preterm infants with persistent pulmonary hypertension insert ignore into journalissuearticles values(PHT); who responded and did not respond to iNO therapy . Material and Method: We retrospectively reviewed data of infants <34 weeks of gestational age with hypoxic respiratory failure that received iNO for PHT after being diagnosed with severe respiratory distress syndrome after birth. The data of responders and non-responders to iNO therapy were compared. Results: Twenty-five infants were included in our study. Twelve insert ignore into journalissuearticles values(48%); had a positive response to iNO administration for PHT. As an antenatal characteristic, oligohydramnios was significantly higher in responders [5 insert ignore into journalissuearticles values(41.7%); vs 0%, p=0.015] and mortality rate was lower insert ignore into journalissuearticles values(66% vs. 100%, p=0.039);. The SpO2/FiO2 ratio before iNO treatment predicted the response to iNO in preterm neonates with PHT. The ROC analysis yielded an area under curve AUC for SpO2/FiO2 ratio before iNO of AUCSpO2/FiO2before was 0.756; 95% CI, 0.554-0.959; P=0.03. A cut-off value of 79 point by the SpO2/FiO2 ratio before iNO treatment predicted the response to iNO treatment with 83% sensitivity and 70% specificity. Conclusion: In infants born <34 weeks gestation, response to iNO in PHT has a significant effect on improving survival. The presence of oligohydramnios may be an important factor in prediction of positive response. SpO2/FiO2 ratio can be useful for estimating the effectiveness of iNO.
Keywords : Nitric oxide therapy, premature, pulmonary hypertension