Effect of conventional ventilation and inhaled nitric oxide In Infants with persistent pulmonary hypertension of the newborn / 中国小儿急救医学

ABSTRACT

Objective To evaluate the effects of inhaled nitric oxide (iNO) therapy combined with conventional ventilation in the infants with persistent pulmonary hypertension of the newborn (PPHN).Methods NO inspiration was added for 22 infants with PPI-IN ventilated with FiO2≥0. 9,PIP≥30 cm H2O,PEEP≥3 cm H2O,RR≥50 bpm for 4～6 hours,with SpO2 still < 90% and PaO2 <55 mm Hg. The iNO concentration started at (10～20)×10-6 for 20 infants,and (20～40)×10-6 for 2 infants. The iNO would be stopped when the concentration reached 40×10 -6 without any sign of improvement. The SpO2 ,blood gas analyses,blood pressure, heart rate and NO concentration were moraitored during therapy and the resulting data compared to readings before administration of int. Results Clinical situation were significantly improved in 20 (91%) of the infants with SpO2 gradually going up after 10 minutes of int. Before iNO,mean Fit2 was 0. 9±0. 1 ,SpO2 was(76. 3±13.3)% ,and Pat2 was (46. 4±10. 1 ) man Hg. From 1 to 6 hours after iNO,SpO2 increased to(95. 1±3.8)% ,Pat2 increased to(92. 8±24.7) mm Hg,FiO2 decreased to 0.6 s0. 1.The differences were significant (P < 0. 01 ). Eighteen of 22 (82%) infants surviving. Conclusion iNO is effective in alleviating PPHN in infants. There are no remarkable side effects. It is more beneficial to start the iNO concentration at (10～20)×10-6 while some infants may need NO concentration at up to (20～40)×10-6.