Source
Department of Neonatal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan. yutanaka@msic.med.osaka-cu.ac.jp
Abstract
OBJECTIVE:
The aim was to determine whether inhaled nitric oxide therapy improves neurodevelopmental outcomes for infants with preterm persistent pulmonary hypertension of the newborn.
METHODS:
We conducted a historical cohort study to compare the 3-year incidence of cerebral palsy in preterm singleton infants (< 34 gestational weeks) with hypoxemic respiratory failure caused by persistent pulmonary hypertension of the newborn who received inhaled nitric oxide (16 patients) or 100% oxygen (15 patients) therapy. All neonates had clinical and echocardiographic evidence of pulmonary hypertension without structural heart disease.
RESULTS:
The incidence of cerebral palsy among patients treated with inhaled nitric oxide was 12.5%, whereas that among patients treated with 100% oxygen was 46.7%. After adjustment for maternal fever (> or = 38 degrees C) during delivery, birth weight, Apgar score at 5 minutes, high-frequency oscillatory ventilation, and surfactant therapy, inhaled nitric oxide therapy, compared with 100% oxygen therapy, was associated with a decreased risk of cerebral palsy in preterm infants with persistent pulmonary hypertension of the newborn.
CONCLUSION:
Inhaled nitric oxide therapy decreases the risk of cerebral palsy in preterm infants with persistent pulmonary hypertension of the newborn.