Effect of inhaled nitric oxide with mechanical ventilation in persistent pulmonary hypertension of newborn / 中国小儿急救医学

ABSTRACT

Objective To study the clinical effect of inhaled nitric oxide ( iNO) with mechanical ventilation for the neonates with persistent pulmonary hypertension of newborn(PPHN). Methods A total of 40 neonates with PPHN poorly responding with routine treatment were treated with iNO therapy. Pulmona-ry artery pressure,blood gas ion analysis and respiratory function changes were observed at different time points before and after iNO. Results Treatment with iNO resulted in a rapid decrease in pulmonary artery pressure from(54. 95 ± 17. 08) mmHg(1 mmHg＝0. 133 kPa) to(20. 40 ± 14. 26) mmHg. Oxygenation of 40 cases improved in the first 0. 5 ~1 hour after iNO therapy,the values of mean airway pressure(MAP) de-clined from(13. 98 ± 2. 40) cmH2 O(1 cmH2 O＝0. 098 kPa) to(12. 44 ± 2. 69) cmH2O,oxygenation index (OI)decreased from 26. 89 ± 18. 62 to 13. 84 ± 5. 52,PaO2/FiO2 increased from(60. 34 ± 23. 49) mmHg to (144. 46 ± 23. 49) mmHg,and the value of pH increased from 7. 31 ± 0. 14 to 7. 37 ± 0. 07. Furthermore, within 48 hours after treatment,PaO2/FiO2 and pH increased gradually,while MAP and OI decreased gradu-ally,which all had statistical differences(P<0. 01). Conclusion Mechanical ventilation combined with iNO therapy in the treatment of PPHN can rapidly improve the oxygenation status of neonates,reduce pulmonary vascular resistance,and then improve the survival rate and long-term prognosis.