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Nitric Oxide May Benefit Some Premature Infants

Less critically ill newborns may benefit from inhaled nitric oxide

WEDNESDAY, July 26 (HealthDay News) -- Inhaled nitric oxide (NO) treatment may have some benefit for premature infants with respiratory failure, although benefits may be limited to those who are less critically ill, according to two reports in the July 27 issue of the New England Journal of Medicine.

John Kinsella, M.D., of Children's Hospital in Denver, and colleagues tested the safety and efficacy of NO therapy in premature newborns, weighing between 500 and 1,250 grams, randomized to 21 days of either 5 ppm inhaled NO or placebo. Overall, no differences in death rates or bronchopulmonary dysplasia were noted. However, newborns weighing at least 1,000 grams showed a lower incidence of respiratory failure and brain injury with NO.

In the second study, Roberta Ballard, M.D., of the Children's Hospital of Philadelphia, and colleagues conducted a similar placebo-controlled trial in premature infants requiring mechanical ventilation between seven and 21 days of age. Infants without bronchopulmonary dysplasia who received decreasing amounts of NO (20 to 5 ppm) over 24 days showed improved survival at 36 weeks, compared with controls (43.9 percent versus 36.8 percent).

The authors have received grants, consulting fees and lecture fees from INO Therapeutics, Bunnell, Inhibitex and Viasys.

"In the most critically ill infants with extremely low birth weights, inhaled nitric oxide does not appear to improve survival or bronchopulmonary dysplasia and…cannot be recommended," states an accompanying editorial.

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