The clinic effect and safety of inhaled nitric oxide for the neonates with hypoxic respiratory failure / 中国小儿急救医学

ABSTRACT

Objective To study the clinic effect and safety of inhaled nitric oxide for the neonates with hypoxic respiratory failure. Methods A total of 21 neonates with hypoxic respiratory failure were trea-ted with nitric oxide inhalation after ineffective treatment of conventional mechanical ventilation. The values of mean airway pressure( MAP) ,oxygenation index( OI) ,mean blood pressure and saturation of blood oxy-gen percutem( TcSaO2 ) were detected before and after nitric oxide inhalation. Meanwhile,the values of coag-ulation function,nitrogen dioxide concentration and methaemoglobin were monitored. Results The lung oxy-genation of 21 cases were significantly improved in 48 hours after nitric oxide inhalation,OI declined from 26. 600 ±4. 169 to 7. 500 ±1. 716,MAP decreased from(15. 100 ±2. 132)cmH2O(1 cmH2O=0. 098 kPa) to (8. 000 ± 0. 816) cmH2O,which all had statistical differences(P <0. 01). The monitoring of coagulation function was in the normal range. The levels of methaemoglobin were less than 3% and nitrogen dioxide less than 1 × 10 -6 . In this study,18 neonates survived,2 neonates died and 1 neonate gave up treatment. Conclu-sion Inhaled nitric oxide early can improve oxygenation effectively for neonates with hypoxic respiratory failure without obvious side-effect. However,it is not yet clear for its long-term prognosis and whether there is influence development of the nervous system.