Inhaled nitric oxide as a rescue therapy in a preterm neonate with severe pulmonary hypertension: a case report

Italian Journal of Pediatrics
Martina BusèVincenzo Duca

Abstract

Inhaled nitric oxide (iNO) has been approved for the treatment of persistent pulmonary hypertension of the newborn (PPHN) in term and near-term newborns. Its role in the management of persistent pulmonary hypertension in preterm infants is not clear. Although guidelines do not exist, some studies have shown that iNO could be used as a rescue therapy in preterm neonate with severe pulmonary hypertension. We describe the case of a preterm neonate, born at 30 + 1 weeks of gestation, with hypoxic respiratory failure not responding to maximal conventional therapy. On the third day of life echocardiography showed severe pulmonary hypertension with right to left shunt and therapy with iNO was started. We achieved a rapid improvement in clinical conditions and pulmonary pressure normalized after 42 h of treatment. Moving on a case by case basis, treatment with iNO should be considered as a rescue therapy in preterm newborns with acute hypoxic respiratory failure caused by severe pulmonary hypertension.

References

Feb 27, 1997·The New England Journal of Medicine·UNKNOWN Neonatal Inhaled Nitric Oxide Study Group
Nov 1, 2000·Critical Care : the Official Journal of the Critical Care Forum·S Al-Alaiyan, E Neiley
Jun 21, 2006·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Carlo BelliniGiovanni Serra
Jul 28, 2006·The New England Journal of Medicine·John P KinsellaSteven H Abman
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Jan 4, 2017·The Cochrane Database of Systematic Reviews·Keith J BarringtonThomas Pennaforte
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