Infants born prematurely at very low birth weights who are treated with inhaled nitric oxide in the neonatal intensive care unit are significantly less likely to need bronchodilators and other respiratory medications after discharge, a study shows.
Infants born prematurely are at increased risk for a chronic lung disease, called bronchopulmonary dysplasia or BPD, associated with prolonged use of oxygen therapy or a respirator. Inhaled nitric oxide therapy has been shown to be effective in treating lung disease in full-term infants.
Dr. Anna Maria Hibbs, of Case Western Reserve University, Cleveland, Ohio, and colleagues examined the value of inhaled nitric oxide in preterm infants (weighing less than 1250 grams) between seven and 21 days of age who were ventilated and at high risk for BPD.
Of 536 infants discharged, 455 (85 percent) were assessed at 12 months; 230 had received inhaled nitric oxide and 225 had received placebo.
At follow up, the researchers found that infants treated with inhaled nitric oxide received significantly less bronchodilators, inhaled steroids, oral steroids, diuretics, and home oxygen compared infants who received placebo.
"Lung disease remains one of the most common sequelae of premature birth," Hibbs and colleagues note in the Journal of Pediatrics. "Many very low birth weight infants with and without history of BPD continue to have symptomatic pulmonary disease in the first years after discharge from neonatal intensive care."
The current study, they conclude, suggests that inhaled nitric oxide may have benefits in preterm low birth weight infants.