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Chapter 8,875

Inhaled nitric oxide during extracorporeal membrane oxygenation for the treatment of severe persistent pulmonary hypertension of the newborn

Müller, W.; Kachel, W.; Lasch, P.; Varnholt, V.; König, S.

Artificial Organs 20(1): 60-63

1996

ISSN/ISBN: 0160-564X
PMID: 8645132
DOI: 10.1111/j.1525-1594.1996.tb04420.x
Accession: 008874097
Inhaled nitric oxide (NO) as a complementary treatment was studied in 10 neonates during extracorporeal membrane oxygenation (ECMO) therapy of various persistent pulmonary hypertension of the newborn (PPHN)-associated diseases. At individually different levels of inhaled NO (20-80 ppm), the mean PaO-2 increased by 59.7% in 6 responders, but it remained unchanged in 4 nonresponders. Adverse side effects of the NO inhalation were tolerable. It was associated with a reversible decrease of the mean arterial blood pressure in 1 patient. During prolonged NO inhalation, the methemoglobin (met-Hb) level increased to 0.9-4.6% in 6 patients. Based on these preliminary results, we conclude that inhaled NO during ECMO can improve oxygenation in some PPHN patients. Further studies with control groups are needed to determine whether inhaled NO can shorten ECMO treatment or improve the rate of survival among PPHN patients.

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Related References

Muller, W.; Kachel, W.; Lasch, P.; Varnholt, V.; Konig, S.A. 1996: Inhaled nitric oxide for avoidance of extracorporeal membrane oxygenation in the treatment of severe persistent pulmonary hypertension of the newborn Intensive Care Medicine 22(1): 71-76
Pfenninger, J.; Bachmann, D.C.; Wagner, B.P. 1997: Inhaled nitric oxide for avoidance of extracorporeal membrane oxygenation in the treatment of severe persistent pulmonary hypertension of the newborn Intensive Care Medicine 23(2): 233
Takata, M.; Miyasaka, K.; Sakai, H.; Fujiwara, H.; Ito, Y.; Kawano, T. 1995: Inhaled nitric oxide and extracorporeal membrane oxygenation in persistent pulmonary hypertension of the newborn Acta Paediatrica Japonica: Overseas Edition 37(2): 171-173
Hoffman, G.M.; Ross, G.A.; Day, S.E.; Rice, T.B.; Nelin, L.D. 1997: Inhaled nitric oxide reduces the utilization of extracorporeal membrane oxygenation in persistent pulmonary hypertension of the newborn Critical Care Medicine 25(2): 352-359
Christou, H.; Van Marter, L.J.; Wessel, D.L.; Allred, E.N.; Kane, J.W.; Thompson, J.E.; Stark, A.R.; Kourembanas, S. 2000: Inhaled nitric oxide reduces the need for extracorporeal membrane oxygenation in infants with persistent pulmonary hypertension of the newborn Critical Care Medicine 28(11): 3722-3727
Turbow, R.; Waffarn, F.; Yang, L.; Sills, J.; Hallman, M. 1995: Variable oxygenation response to inhaled nitric oxide in severe persistent pulmonary hypertension of the newborn Acta Paediatrica 84(11): 1305-1308
Davidson, D.; Barefield, S.J.hn, E.S.; Kattwinkel, J.; Dudell, G.; Straube, R.; Rhines, J.; Chang, C.T. 1999: Acute improvement in oxygenation as a predictor for successful, early treatment of persistent pulmonary hypertension of the newborn using inhaled nitric oxide Pediatric Research 45(4 Part 2): 300A
Davidson, D; Barefield-St John, E S; Kattwinkel, J; Dudell, G; Straube, R; Rhines, J; Chang, C T 1999: Acute Improvement in Oxygenation as a Predictor for Successful, Early Treatment of Persistent Pulmonary Hypertension of the Newborn (PPHN) Using Inhaled Nitric Oxide (I-NO) Pediatric Research 45(4 Part 2): 300a-300a
Wessel, D.L.; Adatia, I.; Van Marter, L.J.; Thompson, J.E.; Kane, J.W.; Stark, A.R.; Kourembanas, S. 1997: Improved oxygenation in a randomized trial of inhaled nitric oxide for persistent pulmonary hypertension of the newborn Pediatrics 100(5): E7
Parker, T.A.; Kinsella, J.P.; Abman, S.H. 1998: Response to inhaled nitric oxide in persistent pulmonary hypertension of the newborn: relationship to baseline oxygenation Journal of Perinatology: Official Journal of the California Perinatal Association 18(3): 221-225
Wessel, D. L.; Adatia, I.; Van Marter, L. J.; Thompson, J. E.; Kane, J. W.; Stark, A. R.; Kourembanas, S. 1997: Improved Oxygenation in a Randomized Trial of Inhaled Nitric Oxide for Persistent Pulmonary Hypertension of the Newborn Pediatrics 100(5): E7-E7
Juliana, A.E.; Abbad, F.C.B. 2005: Severe persistent pulmonary hypertension of the newborn in a setting where limited resources exclude the use of inhaled nitric oxide: successful treatment with sildenafil European Journal of Pediatrics 164(10): 626-629
Varnholt, V.; Lasch, P.; Suske, G.; Kachel, W.; Brands, W. 1992: High frequency oscillatory ventilation and extracorporeal membrane oxygenation in severe persistent pulmonary hypertension of the newborn European Journal of Pediatrics 151(10): 769-774
Sabharwal, A.J.; Davis, C.F.; Heales, S.; Land, J.; Maclean, M.R. 1998: Fluctuation in whole blood 5-hydroxytryptamine levels in neonatal pulmonary hypertension during extracorporeal membrane oxygenation and inhaled nitric oxide therapy European Respiratory Journal 12(Suppl 28): 90S
Chen, Y.-L.; Yang, X.-F.; Chen, J.; Shi, S.-W.; Zhu, Q.-W.; Liao, X.-Z.; Zhang, M.-G. 2022: Application of extracorporeal membrane oxygenation in the treatment of persistent pulmonary hypertension of the newborn Zhongguo Dang Dai Er Ke Za Zhi 24(7): 786-791