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Acute Effects of Inhaled Nitric Oxide on Pulmonary and Cardiac Function in Preterm Infants with Evolving Bronchopulmonary Dysplasia

Journal of Perinatology volume 24, pages 769–774 (2004)Cite this article

Abstract

BACKGROUND: Inhaled nitric oxide (iNO) reduces pulmonary vascular resistance by preferential vasodilation in ventilated lung units. In experimental animals, iNO also reduces airway resistance by smooth muscle relaxation. Hence, there may be a therapeutic role for iNO in evolving bronchopulmonary dysplasia (BPD).

OBJECTIVE: To evaluate the acute effects of low-dose iNO on lung mechanics, ventilation distribution, oxygenation, and cardiac function in preterm infants with evolving BPD.

METHODS: Measurements of lung compliance (CL), airway resistance (RL), ventilation-distribution (N2 clearance in multiple-breath washout), oxygenation (SpO2), left ventricular ejection fraction (LVEF) and right ventricular shortening fraction were obtained before and during 2 hours of iNO (10 ppm) in a group of ventilated preterm infants with evolving BPD.

RESULTS: A total of 13 preterm infants with (mean±SD) BW: 663.8±116 g, GA: 24.9±1.2 weeks, age: 32±14 days, mean airway pressure: 6.7±0.9 cmH2O and fraction of inspired oxygen: 0.35±0.06 were studied. iNO did not affect CL, RL or N2 clearance. There was a small increase in LVEF. Mean SpO2 remained unchanged, but the duration of spontaneous hypoxemic episodes increased during iNO.

CONCLUSION: Low-dose iNO had no acute effects on lung function, cardiac function and oxygenation in evolving BPD.

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Authors and Affiliations

  1. Divisions of Neonatology and Cardiology, University of Miami School of Medicine, Miami, FL, USA

    Sethuraman Swaminathan MD

  2. Department of Pediatrics, University of Miami School of Medicine, Miami, FL, USA

    Kamlesh Athavale MD, Nelson Claure PhD, Carmen D'Ugard RRT, Ruth Everett RRT & Eduardo Bancalari MD

Authors
  1. Kamlesh Athavale MD
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  2. Nelson Claure PhD
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  3. Carmen D'Ugard RRT
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  4. Ruth Everett RRT
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  5. Sethuraman Swaminathan MD
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  6. Eduardo Bancalari MD
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Additional information

Supported by the University of Miami Project NewBorn.

Additional support provided by Forest Pharmaceuticals Inc.

Presented in part at the 2002 meeting of the Pediatric Academic Societies.

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Athavale, K., Claure, N., D'Ugard, C. et al. Acute Effects of Inhaled Nitric Oxide on Pulmonary and Cardiac Function in Preterm Infants with Evolving Bronchopulmonary Dysplasia. J Perinatol 24, 769–774 (2004). https://doi.org/10.1038/sj.jp.7211216

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