Time limits for a failed response to inhaled nitric oxide in newborn infants with persistent pulmonary hypertension: A retrospective observational study

2010 ◽  
Vol 3 (2) ◽  
pp. 141-146
Author(s):  
Husam Salama ◽  
Wissam Adlburaki ◽  
Amani Saeed Ibrahim ◽  
Samawal Lutfi ◽  
Nawal Magzoob
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Observational Study ◽  
Newborn Infants ◽  
Inhaled Nitric Oxide ◽  
Persistent Pulmonary Hypertension ◽  
Retrospective Observational Study ◽  
Time Limits

scholarly journals Factors Affecting the Response to Inhaled Nitric Oxide Therapy in Persistent Pulmonary Hypertension of the Newborn Infants

2004 ◽  
Vol 45 (1) ◽  
pp. 49 ◽  
Author(s):  
Soo Jung Hwang ◽  
Kye Hyang Lee ◽  
Jong Hee Hwang ◽  
Chang Won Choi ◽  
Jae Won Shim ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Newborn Infants ◽  
Inhaled Nitric Oxide ◽  
Persistent Pulmonary Hypertension ◽  
Factors Affecting ◽  
Nitric Oxide Therapy

Longitudinal follow-up of a cohort of newborn infants treated with inhaled nitric oxide for persistent pulmonary hypertension

1997 ◽  
Vol 131 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Adam A. Rosenberg ◽  
Jan M. Kennaugh ◽  
Susan G. Moreland ◽  
Lucy M. Fashaw ◽  
Kathy A. Hale ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Newborn Infants ◽  
Inhaled Nitric Oxide ◽  
Persistent Pulmonary Hypertension

scholarly journals SOD and inhaled nitric oxide normalize phosphodiesterase 5 expression and activity in neonatal lambs with persistent pulmonary hypertension

2010 ◽  
Vol 299 (1) ◽  
pp. L109-L116 ◽  
Author(s):  
Kathryn N. Farrow ◽  
Satyan Lakshminrusimha ◽  
Lyubov Czech ◽  
Beezly S. Groh ◽  
Sylvia F. Gugino ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Soluble Guanylate Cyclase ◽  
Pulmonary Arteries ◽  
Newborn Infants ◽  
Inhaled Nitric Oxide ◽  
Persistent Pulmonary Hypertension ◽  
The Impact ◽  
Phosphodiesterase 5 ◽  
Expression And Activity

Phosphodiesterase 5 (PDE5) and soluble guanylate cyclase (sGC) are key regulators of cGMP and pulmonary vascular tone. We sought to determine the impact of mechanical ventilation with O2 with or without inhaled nitric oxide (iNO) or recombinant human Cu/Zn SOD (rhSOD) on sGC, PDE5, and cGMP in the ovine ductal ligation model of persistent pulmonary hypertension of the newborn (PPHN). PPHN lambs were ventilated with 100% O2 for 24 h alone or combined with either inhalation of 20 parts per million (ppm) iNO continuously or a single intratracheal dose of rhSOD (5 mg/kg). Ventilated PPHN lambs were compared with PPHN fetuses, control fetuses, and 1-day-old spontaneously breathing lambs (1DSB). In the small pulmonary arteries of 1DSB lambs, sGC expression increased, PDE5 expression decreased, and cGMP concentrations increased relative to fetal levels. In PPHN lambs ventilated with 100% O2, sGC activity increased to levels comparable with 1DSB levels. However, PDE5 expression and activity increased, and cGMP levels remained at fetal levels. Addition of either iNO or rhSOD decreased PDE5 expression and activity in PPHN lambs and increased cGMP levels to levels comparable with 1DSB lambs. These data suggest that ventilation of PPHN lambs with 100% O2 impairs cGMP-mediated vasodilation in part due to increased PDE5 expression and activity. The addition of either iNO or rhSOD normalized PDE5 and cGMP levels. Thus therapies designed to decrease PDE5 and increase cGMP, such as iNO and rhSOD, may prove useful in the treatment of PPHN in newborn infants.

scholarly journals Inhaled Nitric Oxide at Birth Reduces Pulmonary Vascular Resistance and Improves Oxygenation in Preterm Lambs

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 378
Author(s):  
Satyan Lakshminrusimha ◽  
Sylvia F. Gugino ◽  
Krishnamurthy Sekar ◽  
Stephen Wedgwood ◽  
Carmon Koenigsknecht ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Pulmonary Vascular Resistance ◽  
Preterm Infants ◽  
Vascular Resistance ◽  
Inhaled Nitric Oxide ◽  
Persistent Pulmonary Hypertension ◽  
Inhaled No ◽  
Birth Preterm

Resuscitation with 21% O2 may not achieve target oxygenation in preterm infants and in neonates with persistent pulmonary hypertension of the newborn (PPHN). Inhaled nitric oxide (iNO) at birth can reduce pulmonary vascular resistance (PVR) and improve PaO2. We studied the effect of iNO on oxygenation and changes in PVR in preterm lambs with and without PPHN during resuscitation and stabilization at birth. Preterm lambs with and without PPHN (induced by antenatal ductal ligation) were delivered at 134 d gestation (term is 147–150 d). Lambs without PPHN were ventilated with 21% O2, titrated O2 to maintain target oxygenation or 21% O2 + iNO (20 ppm) at birth for 30 min. Preterm lambs with PPHN were ventilated with 50% O2, titrated O2 or 50% O2 + iNO. Resuscitation with 21% O2 in preterm lambs and 50%O2 in PPHN lambs did not achieve target oxygenation. Inhaled NO significantly decreased PVR in all lambs and increased PaO2 in preterm lambs ventilated with 21% O2 similar to that achieved by titrated O2 (41 ± 9% at 30 min). Inhaled NO increased PaO2 to 45 ± 13, 45 ± 20 and 76 ± 11 mmHg with 50% O2, titrated O2 up to 100% and 50% O2 + iNO, respectively, in PPHN lambs. We concluded that iNO at birth reduces PVR and FiO2 required to achieve target PaO2.

Methemoglobin and the response to inhaled nitric oxide in persistent pulmonary hypertension of the newborn

2020 ◽  
Vol 13 (2) ◽  
pp. 175-182
Author(s):  
R. Dadiz ◽  
J. Nair ◽  
C.T. D’Angio ◽  
R.M. Ryan ◽  
S. Lakshminrusimha
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Inhaled Nitric Oxide ◽  
Persistent Pulmonary Hypertension

Recombinant Human Superoxide Dismutase Enhances the Effect of Inhaled Nitric Oxide in Persistent Pulmonary Hypertension

2001 ◽  
Vol 164 (5) ◽  
pp. 834-839 ◽  
Author(s):  
ROBIN H. STEINHORN ◽  
GEORGE ALBERT ◽  
DANIEL D. SWARTZ ◽  
JAMES A. RUSSELL ◽  
CAROLYN R. LEVINE ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Superoxide Dismutase ◽  
Inhaled Nitric Oxide ◽  
Persistent Pulmonary Hypertension

The effect of inhaled nitric oxide therapy on thromboelastogram in newborns with persistent pulmonary hypertension

2014 ◽  
Vol 173 (10) ◽  
pp. 1381-1385 ◽  
Author(s):  
Sema Tanriverdi ◽  
Ozge Altun Koroglu ◽  
Ozgun Uygur ◽  
Can Balkan ◽  
Mehmet Yalaz ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Inhaled Nitric Oxide ◽  
Persistent Pulmonary Hypertension ◽  
Nitric Oxide Therapy

Four Patterns of Response to Inhaled Nitric Oxide for Persistent Pulmonary Hypertension of the Newborn

PEDIATRICS ◽  
1996 ◽  
Vol 98 (4) ◽  
pp. 706-713 ◽  
Author(s):  
Allan P. Goldman ◽  
Robert C. Tasker ◽  
Sheila G. Haworth ◽  
Paul E. Sigston ◽  
Duncan J. Macrae
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Time Course ◽  
Pulmonary Hypoplasia ◽  
Oxygenation Index ◽  
Pediatric Intensive Care ◽  
Inhaled Nitric Oxide ◽  
Persistent Pulmonary Hypertension ◽  
Clinical Role ◽  
Initial Trial

Objective. To determine the clinical role of inhaled nitric oxide (iNO) in the treatment of persistent pulmonary hypertension of the newborn (PPHN). Study Design. Prospective open observational clinical study. Setting. A regional cardiac and pediatric intensive care unit. Methods. Twenty-five consecutive near-term neonates (>35 weeks gestation) with severe PPHN (oxygenation index [OI]> 25) were given a trial of iNO of 20 ppm for 20 minutes. Neonates who showed a greater than 20% improvement in Pao 2 as well as a decrease in the OI to below 40 were defined as responders and continued on this therapy. Results. Four patterns of response emerged to the iNO therapy: Pattern 1 neonates (n = 2) did not respond to the initial trial of iNO—one survived. Pattern 2 neonates (n = 9) responded to the initial trial of iNO, but failed to sustain this response over 36 hours, as defined by a rise in the OI to >40. Six survived, five with extracorporeal membrane oxygenation. Pattern 3 neonates (n = 11) responded to the initial trial of iNO, sustained this response, and were successfully weaned from iNO within 5 days—all survived to discharge. Pattern 4 neonates (n = 3) responded to the initial trial of iNO, but developed a sustained dependence on iNO for 3 to 6 weeks. All three died and lung histology revealed severe pulmonary hypoplasia and dysplasia. These neonates (pattern 4) not only required iNO for a longer period of time than did the sustained responders (pattern 3), but they required significantly higher doses of iNO during their first 5 days of iNO therapy. Conclusions. Early responses to iNO may not be sustained. Neonates with pulmonary hypoplasia and dysplasia may have a decreased sensitivity and differing time course of response to iNO when compared with patients who have PPHN in fully developed lungs.

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