Neonatal Med.  2015 May;22(2):55-60. 10.5385/nm.2015.22.2.55.

Clinical Indications for Inhaled Nitric Oxide Therapy in Neonates

Affiliations
  • 1Department of Pediatrics, Hallym University College of Medicine, Seoul, Korea. neosung@hallym.or.kr

Abstract

Nitric oxide (NO) is a colorless, odorless gas that acts as a potent pulmonary vasodilator. When administered via inhalation, NO rapidly diffuses across the alveolarcapillary membrane and binds to hemoglobin, and thus has little effect on the systemic circulation. NO was approved by the United States Food and Drug Administration (US FDA) for the treatment of hypoxic respiratory failure associated with pulmonary hypertension in 1999. Neonatal hypoxic respiratory failure may be caused by persistent pulmonary hypertension of the newborn and other diseases such as meconium aspiration syndrome, sepsis, birth asphyxia, and respiratory distress syndrome that contribute to pulmonary arterial hypertension. Inhaled NO is the only approved treatment in term and late preterm (>34 weeks) neonates with hypoxic respiratory failure associated with pulmonary hypertension, and it reduces the need for extracorporeal membrane oxygenation. The present article will review the clinical indications for US FDA-approved inhaled NO therapy according to evidence-based clinical studies.

Keyword

Neonatal hypoxic respiratory failure; Nitric oxide; Persistent pulmonary hypertension of newborn

MeSH Terms

Asphyxia
Extracorporeal Membrane Oxygenation
Female
Humans
Hypertension
Hypertension, Pulmonary
Infant, Newborn*
Inhalation
Meconium Aspiration Syndrome
Membranes
Nitric Oxide*
Parturition
Persistent Fetal Circulation Syndrome
Respiratory Insufficiency
Sepsis
United States Food and Drug Administration
Nitric Oxide
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