Inhaled nitric oxide (iNO), a therapy used in the treatment of premature newborns with respiratory failure that had shown promising results in short-term studies, does not significantly improve long-term outcomes, according to a national study led by critical care researchers at the University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh of UPMC.
Previous studies of inhaled nitric oxide in premature babies with respiratory failure suggested improvements in early outcomes, but this study of nearly 800 infants found no significant improvement in survival rates at 1 year of age and no change in longer term respiratory or neurological function.
"We were surprised by these findings, because previous studies had suggested short-term benefits of iNO in the treatment of respiratory failure," said first author R. Scott Watson, M.D., M.P.H., assistant professor of critical care medicine and pediatrics, University of Pittsburgh School of Medicine, and an intensivist in the Division of Critical Care Medicine at Children's Hospital and a researcher in the Clinical Research, Investigation & Systems Modeling of Acute Illness (CRISMA) Laboratory in the Department of Critical Care Medicine. "Further study will determine if a different dose, longer duration of therapy and/or use in a different subgroup of premature babies would be effective."
Results of the study are published in the November issue of Pediatrics, the official journal of the American Academy of Pediatrics.
Researchers conducted long-term follow-up of premature newborns from 16 centers in the United States who were born at 34 weeks or earlier and weighed between 500 and 1,250 grams and were enrolled in a study testing whether iNO could prevent chronic lung disease. Babies received five parts per million of iNO or a placebo within the first two days of birth and continuing for 21 days (or until the patient was taken off a ventilator). Of the 590 babies with complete survival data, 77 percent survived to one year of age (79 percent of those receiving iNO and 75 percent of those receiving placebo).