Background: We have shown earlier that inhaled nitric oxide (iNO) administered by oxygen hood reduces pulmonary hypertension in an animal model (J Perinatol 2002; 22:50-6). Our objective in this study was to determine feasibility of iNO by oxygen hood in neonates with elevated alveolar-arterial oxygen gradients (A-aDO(2)).
Methods/principal Findings: Masked randomized controlled pilot trial. Inclusion criteria were: gestation>or=34 weeks, age<7 days, with post-ductal arterial line, and A-aDO(2) 400-600. Infants were randomized to study gas (iNO 20 ppm or equivalent O(2) flow) for 1 hr which was then weaned over the next 4 hours. Primary outcome was PaO(2) one hour post-randomization. Four infants each were randomized to iNO or O(2) (controls). Two of the four infants given iNO had an increase in PaO(2) of >100 torr, while oxygenation was unchanged in the controls. Methemoglobinemia and other adverse effects were not noted in any infant. Environmental levels of NO and NO(2) were minimal (<1 ppm) at >0.3 m from the hood.
Conclusions: Administration of iNO by oxygen hood is feasible. Larger randomized controlled trials are required to measure the efficacy and determine an appropriate target population for this technique.
Trial Registration: ClinicalTrials.gov NCT00041548.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629563 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0004312 | PLOS |
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