Response to Inhaled Nitric Oxide and Clinical Outcome in Very Low Birth Weight Infants with Early Pulmonary Hypertension

Jae-Young Cho; Byong Sop Lee; Moon Yeon Oh; Teahyen Cha; Jiyoon Jeong; Euiseok Jung; Ai-Rhan Kim; Ki-Soo Kim

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자료유형: 학술저널

저자정보: Jae-Young Cho (Gyeongsang National University) Byong Sop Lee (University of Ulsan) Moon Yeon Oh (University of Ulsan) Teahyen Cha (University of Ulsan) Jiyoon Jeong (University of Ulsan) Euiseok Jung (University of Ulsan) Ai-Rhan Kim (University of Ulsan) Ki-Soo Kim (University of Ulsan College of Medicine)

저널정보: 대한신생아학회 Neonatal medicine Neonatal medicine 제27권 제3호

발행연도: 2020.1

수록면: 133 - 140 (8page)

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Purpose: To determine the efficacy of inhaled nitric oxide (iNO) in very low birth weight (VLBW) infants with early pulmonary hypertension (PH). Methods: We reviewed the medical records of 22 preterm infants who were born <30 weeks of gestational age with birth weight <1,500 g, diagnosed with early PH, and treated with iNO within the first 72 hours after birth. Responders were defined by a reduction in FiO2 >20% and/or oxygenation index (OI) >20% from the baseline values at 1 hour after beginning iNO therapy. Cardiorespiratory support indices including OI, oxygen saturation index, and vasoactive-inotropic score (VIS) were serially obtained for 96 hours following iNO therapy. Results: The mean gestational age of the patients was 26.1±2.0 weeks and the mean birth weight was 842±298 g. The mean OI at the start of iNO was 63.8±61.0. Improvement in oxygenation indicated by prompt decrease in FiO2 and OI from the baseline values were observed 1 hour after beginning iNO therapy and lasted up to 96 hours. After iNO therapy, VIS increased until 24 hours and decreased thereafter. At 1 hour after iNO, 16 patients (73%) were classified as responders and six (27%) as nonresponders. Compared with nonresponders, responders did not demonstrate the beneficial effect of iNO in terms of short-term survival and neonatal complications. The 1-year mortality rate did not differ between responders (56%) and nonresponders (67%). Conclusion: Although iNO treatment immediately improved oxygenation in most VLBW infants with early severe PH, the long-term mortality rate was high. A largescale study is needed to determine whether the initial response to iNO can predict patients’ survival.

#Infant #very low birth weight #Hypertension #pulmonary #Nitric oxide

참고문헌 (30)

참고문헌 신청

Lakshminrusimha S / 2016 / The fetal circulation, pathophysiology of hypoxemic respiratory failure and pulmonary hypertension in neonates, and the role of oxygen therapy / J Perinatol 36(Suppl 2):S3~S11

Barrington KJ / 2017 / Nitric oxide for respiratory failure in infants born at or near term / Cochrane Database Syst Rev 1:CD000399

Lakshminrusimha S / 2015 / Persistent pulmonary hypertension of the newborn / Neoreviews 16:e680~e692

Kumar VH / 2007 / Characteristics of pulmonary hypertension in preterm neonates / J Perinatol 27:214~219

Nakanishi H / 2018 / Persistent pulmonary hypertension of the newborn in extremely preterm infants: a Japanese cohort study / Arch Dis Child Fetal Neonatal Ed 103:F554~F561

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