The early use of iNO in extremely premature neonates with refractory hypoxic respiratory failure
10.3760/cma.j.issn.2096-2932.2023.03.008
- VernacularTitle:吸入一氧化氮在超早产儿早期难治性低氧性呼吸衰竭中的应用
- Author:
Yongping FU
1
;
Xueyu CHEN
;
Haifeng ZONG
;
Jie ZHAO
;
Hui TANG
;
Zhifeng HUANG
;
Chuanzhong YANG
Author Information
1. 南方医科大学附属深圳妇幼保健院新生儿科，深圳 518028
- Keywords:
Extremely premature neonates;
Refractory hypoxic respiratory failure;
Inhaled nitric oxide;
Oxygenation Index
- From:Chinese Journal of Neonatology
2023;38(3):166-170
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the early use of inhaled nitric oxide (iNO) as a rescue therapy in extremely premature infants (EPIs) with refractory hypoxic respiratory failure (HRF).Methods:Between January 2021 and December 2021, EPIs with refractory HRF receiving iNO within the first week of life in our NICU were enrolled. Their clinical characteristics and outcomes were retrospectively analyzed.Results:A total of 11 EPIs were included with 5 males and 6 females. The median gestational age (GA) was 24(22.6, 25.2) weeks. The median birth weight (BW) was 580(490, 770) g. The most common primary diagnoses were moderate/severe respiratory distress syndrome (RDS) (5/11) and early-onset sepsis (3/11). The median age starting iNO therapy was 6.5(4.5, 34.0)h and the median duration of iNO was 24(12, 36)h. The median iNO starting dose was 5(5, 8) ppm and the therapeutic range was 5-20 ppm. Therapeutic efficacy was defined as ≥30% FiO 2 reduction after 6 h of iNO treatment. The treatment was effective in 8 cases. The oxygenation index (OI) decreased more than 10% from baseline 1 h after initiation in 9 patients and in all 11 patients after 12 h of iNO. The reduction of OI was more prominent in EPIs with a higher OI at baseline. Of the 11 patients, 8 survived, 1 died and 2 abandoned further treatments. Conclusions:As an early rescue therapy for EPIs with refractory HRF, iNO can improve oxygenation without obvious short-term adverse effects.
