Nitric Oxide Unhelpful for Premature Babies

Treatment with inhalational nitric oxide (iNO) does not improve survival or the developmental outcomes of premature infants with severe respiratory failure, according to a new study.

Researchers from Stanford University (Palo Alto, CA, USA) examined 420 infants who were born at less than 34 weeks gestational age and weighed less than 1500 g. The subjects, who all had severe respiratory failure, were randomized to receive either iNO or placebo. The main outcome measure was neurodevelopmental impairment at 18 to 22 months corrected age, which included moderate-to-severe cerebral palsy, blindness, or deafness.

The researchers found that iNO therapy did not reduce the occurrence of neurodevelopmental impairment. In fact, iNO therapy was associated with slightly increased risks of cerebral palsy in all infants and death in infants weighing less than 1000 g. The study was published in the July 2007 issue of the Journal of Pediatrics.

"In light of previous analyses suggesting a reduction in adverse neurodevelopmental outcomes when iNO is administered earlier to a less severely ill preterm patient cohort, we await the follow-up studies of recently completed trials to determine the appropriate premature population, optimal timing for initiation of iNO, and length of treatment exposure,” said lead author Susan R. Hintz, M.D., M.Sc., an assistant professor of pediatrics.

The researchers cautioned that until further data become available, clinicians should not routinely use iNO therapy for premature infants outside of a research setting.


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