Original Article

Journal of Perinatology (2007) 27, 347–352; doi:10.1038/sj.jp.7211690; published online 19 April 2007

Inhaled nitric oxide in infants >1500 g and <34 weeks gestation with severe respiratory failure

K P Van Meurs1, S R Hintz1, R A Ehrenkranz2, J A Lemons3, M B Ball1, W K Poole4, R Perritt4, A Das4, R D Higgins5 and D K Stevenson1 for the Preemie Inhaled Nitric Oxide Study

  1. 1Division of Neonatal and Developmental Medicine, School of Medicine and Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, USA
  2. 2Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
  3. 3Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
  4. 4Research Triangle Institute, Research Triangle Park, NC, USA
  5. 5National Institute of Child Health and Human Development, Bethesda, MD, USA

Correspondence: Dr KP Van Meurs, Professor of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, 750 Welch Road, Suite 315, Palo Alto, CA 94304, USA. E-mail: vanmeurs@stanford.edu

Received 29 September 2006; Revised 5 February 2007; Accepted 6 February 2007; Published online 19 April 2007.

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Abstract

Objective:

 

Inhaled nitric oxide (iNO) use in infants >1500 g, but <34 weeks gestation with severe respiratory failure will reduce the incidence of death and/or bronchopulmonary dysplasia (BPD).

Study Design:

 

Infants born at <34 weeks gestation with a birth weight >1500 g with respiratory failure were randomly assigned to receive placebo or iNO.

Results:

 

Twenty-nine infants were randomized. There were no differences in baseline characteristics, but the status at randomization showed a statistically significant difference in the use of high-frequency ventilation (P=0.03). After adjustment for oxygenation index entry strata, there was no difference in death and/or BPD (adjusted relative risk (RR) 0.80, 95% confidence interval (CI) 0.43 to 1.48; P=0.50), death (adjusted RR 1.26, 95% CI 0.47 to 3.41; P=0.65) or BPD (adjusted RR 0.40, 95% CI 0.47 to 3.41; P=0.21).

Conclusions:

 

Although sample size limits our ability to make definitive conclusions, this small pilot trial of iNO use in premature infants >1500 g and <34 weeks with severe respiratory failure suggests that iNO does not affect the rate of BPD and/or death.

Keywords:

inhaled nitric oxide, respiratory failure, premature infant, bronchopulmonary dysplasia

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