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INHALED NITRIC OXIDE IN THE TREATMENT OF PERSISTENT PULMONARY HYPERTENSION IN NEWBORNS WITH MECONIUM ASPIRATION SYNDROME
  1. M Dzimbeg1
  1. 1NICU and PICU, Department of Paediatrics, University Hospital Center Zagreb, Zagreb, Croatia

Abstract

Meconium aspiration syndrome (MAS) is a common severe respiratory disease in full term infants. Since persistent pulmonary hypertension of the newborn (PPHN) is one of the major causes of death in infants with MAS we investigated if the treatment with inhaled nitric oxide (iNO) makes any difference in survival of newborns with MAS and PPHN. We evaluated and compared the results of treatment with iNO with results of other PPHN treatments before use of iNO. The study included 123 newborns with mild to severe form of MAS and PPHN.

The control group included 35 neonates who were not treated with iNO (before iNO era). From those, 22 newborns (63%) were mechanically ventilated. The average time of mechanical ventilation was 6 days and average number of hospital days was 18. Pneumothorax was a treatment complication in 7 (32%). From 22 mechanically ventilated, 12 (55%) died. The second group included 88 newborns, 68 (77%) were mechanically ventilated. In 48 mechanically ventilated newborns iNO was used. Twenty two of them were matched to control and the outcome was compared. The average time of mechanical ventilation in the second group was 8 days and average number of hospital days was 31. Pneumothorax developed in two (9%), three (14%) died, and 19 (86%) were cured.

Conclusion Treatment with iNO statistically improved the outcome and reduced mortality of newborns with severe form of MAS and PPH.

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