ABSTRACT
OBJECTIVE: Our aim was to assess from a clinical and analytical point of view the response to inhaled nitric oxide in patients with persistent pulmonary hypertension of the newborn (PPHN). PATIENTS AND METHODS: A retrospective study was analyzed in ten patients with PPHN who received inhaled nitric oxide. The ventilatory and gasometric data were reviewed before treatment, during the first hours and afterwards, in all patients, in the surviving group and in the most common associated disease group (intrauterine pneumonia). The parameters analyzed to assess the response to NO treatment were the oxygenation index (IO) and the PaO2 increase. Statistical analysis was performed by using a comparison of means. RESULTS: The mean oxygenation index before starting the treatment with inhaled NO was 39 +/- 7.3 in the total group and 38.4 +/- 8.8 in the surviving patients. At 2.9 +/- 1.1 hours after treatment a mild improvement was observed in the total group and it was more evident in the surviving group (32.4 +/- 15.2 and 26.4 +/- 7.8, respectively; p < 0.05). After treatment was discontinued, the IO was 24.7 +/- 21.9 (p < 0.05) and 12.8 +/- 7.5 (p < 0.001). The PaO2 increment in both groups was 51.2 +/- 55.5% and 66.8% +/- 28.1%. The patients with intrauterine pneumonia showed the highest PaO2 increase after treatment was discontinued (78.3% +/- 41.9%). CONCLUSIONS: Early treatment with inhaled NO in term newborns with PPHN produced a sustained improvement in oxygenation. This treatment might reduce the number of patients who need extracorporal membrane oxygenation.
