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Review
. 2020 Feb;109(2):309-313.
doi: 10.1111/apa.14958. Epub 2019 Aug 25.

The immediate efficacy of inhaled nitric oxide treatment in preterm infants with acute respiratory failure during neonatal transport

Felipe Garrido  1   2 , Juan Luis Gonzalez-Caballero  3 , Rachel Lomax  1 , Ian Dady  1
Affiliations
Review

The immediate efficacy of inhaled nitric oxide treatment in preterm infants with acute respiratory failure during neonatal transport

Felipe Garrido et al. Acta Paediatr. 2020 Feb.

Abstract

Aim: The aim of our review was to describe the clinical response to inhaled nitric oxide (iNO) in a series of preterm babies in respiratory failure during uplift transfers to a neonatal intensive care unit.

Methods: We performed a retrospective review of critical newborns with gestational age <34+0 weeks transferred from January 2013 to December 2018. Data were extracted from our Clinical Information System for transport. The primary measure of this review was to assess whether a significant improvement in the oxygenation saturation index (OSI) occurred following the use of iNO.

Results: Thirty preterm babies <34+0 weeks were included in our review. OSI, as a measure of oxygenation, did not statistically improve as an immediate response to iNO from referral to receiving hospital (17.1 vs 16.4; P = .7). We found that pH (7.15 vs 7.29; P = .004) and pCO2 (8.1 vs 6.3; P = .05) significantly improved probably based on ventilation management.

Conclusion: Following the recommendations of the American Academy of Paediatrics and other organizations, iNO should not routinely be used during the neonatal transfer of preterm babies <34+0 in respiratory failure. We need to conduct further studies to establish which selected preterm patients would benefit from being treated with iNO.

Keywords: neonatal transport; nitric oxide administration; premature infants; respiratory failure.

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References

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