Inhaled Nitric Oxide in Hypoxic Respiratory Failure in Preterms: Audit of Ten Years of Practice
Dr. Arvind Sehgal. Department of Newborn Services, Monash Medical Centre, 246, Clayton Road, Clayton, VIC 3168, Australia.E-mail: email@example.com
Objective: We set out to ascertain the patient profile and practice pattern regarding use of inhaled Nitric Oxide (iNO) in preterm population with oxygenation failure in last ten years. Furthermore, we aim to identify characteristics of patients who respond to iNO.
Study Design and Setting: Retrospective chart review in a tertiary teaching referral hospital.
Subjects and Intervention: All preterm babies less than 34 weeks gestation with oxygenation failure who were treated with iNO were assessed for inclusion. Response to iNO therapy was defined as decline in oxygenation index by 50% 4 hours after start of iNO.
Results: iNO was administered to 26 preterm babies during the study period. Of these, 23 (88.5%) met the inclusion criteria. Total of 13 (56%) infants survived. The iNO responders had a higher gestation age (29 weeks Vs 26.5 weeks), birth weight (1279g Vs 999g), lower initial oxygenation index (38.7 Vs 58), earlier initiation of therapy (20 hours Vs 41.4 hours) and less mortality (25% Vs 86%) when compared to non-responders.
Conclusions: Although the infants were at a higher end of spectrum for severity of respiratory illness, nitric administration was successful in improving oxygenation. Characteristics of responders might help in better patient selection and optimize timing of intervention, in case use of Nitric Oxide therapy is being considered.