A Medical Device Daily
A new study from the National Institutes of Health (NIH; Bethesda, Maryland) indicates that inhaled nitric oxide (NO) therapy, used to treat lung problems in premature infants, does not reduce the infant’s chances for death or additional lung problems, contrary to previous findings.
The research was conducted by the NIH’s National Institute of Child Health and Human Development (NICHD).
NICHD enrolled 420 infants born at less than 34 weeks’ gestation, weighing between 14 ounces and 3 pounds, 2 ounces. All infants required assisted ventilation and had a diagnosis of respiratory distress syndrome, sepsis or pneumonia or other severe breathing problems. The infants were randomly assigned to receive either inhaled NO or a placebo.
No difference was found between the infants who received the inhaled NO and those who did not. The study showed that about 60% of the infants who received it and 68% of those who did not developed serious lung inflammation and scarring.
Both groups also had high death rates, 52% in the inhaled NO group and 44% in the control group.
Researchers believe that smaller infants do not have lungs sufficiently developed to benefit from inhaled NO.
Premature infants who undergo this treatment also are at risk for intracranial bleeding. In addition, infants receiving inhaled NO through conventional mechanical ventilation had a higher mortality rate than those receiving the therapy through high-frequency ventilation.
Conventional mechanical ventilation resembles the inhaling and exhaling motion of normal breathing, while high frequency ventilation consists of numerous soft pulses delivered to the lungs.
More research into the recent study findings is required, the study authors said.
The study appears in the July 7 issue of the New England Journal of Medicine.
Inhaled NO therapy is effective for treating full-term infants with lung complications, researchers said. For the treatment, NO gas is mixed with oxygen and given to an infant through a breathing apparatus. The treatment makes the blood vessels in the lung tissue relax, allowing the lungs to absorb oxygen more easily.