Nitric oxide administration using an oxygen hood: a pilot trial.

Academic Article


  • BACKGROUND: We have shown earlier that inhaled nitric oxide (iNO) administered by oxygen hood reduces pulmonary hypertension in an animal model (J Perinatol 2002; 22:50-6). Our objective in this study was to determine feasibility of iNO by oxygen hood in neonates with elevated alveolar-arterial oxygen gradients (A-aDO(2)). METHODS/PRINCIPAL FINDINGS: Masked randomized controlled pilot trial. Inclusion criteria were: gestation>or=34 weeks, age<7 days, with post-ductal arterial line, and A-aDO(2) 400-600. Infants were randomized to study gas (iNO 20 ppm or equivalent O(2) flow) for 1 hr which was then weaned over the next 4 hours. Primary outcome was PaO(2) one hour post-randomization. Four infants each were randomized to iNO or O(2) (controls). Two of the four infants given iNO had an increase in PaO(2) of >100 torr, while oxygenation was unchanged in the controls. Methemoglobinemia and other adverse effects were not noted in any infant. Environmental levels of NO and NO(2) were minimal (<1 ppm) at >0.3 m from the hood. CONCLUSIONS: Administration of iNO by oxygen hood is feasible. Larger randomized controlled trials are required to measure the efficacy and determine an appropriate target population for this technique. TRIAL REGISTRATION: NCT00041548.
  • Published In

  • PLoS ONE  Journal
  • Keywords

  • Administration, Inhalation, Female, Humans, Hypertension, Pulmonary, Infant, Newborn, Infant, Premature, Male, Nitric Oxide, Oxygen, Oxygen Inhalation Therapy, Persistent Fetal Circulation Syndrome
  • Digital Object Identifier (doi)

    Author List

  • Ambalavanan N; El-Ferzli GT; Roane C; Johnson R; Carlo WA
  • Start Page

  • e4312
  • Volume

  • 4
  • Issue

  • 2