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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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CARDIOVASCULAR  SMART 2004 - Milan, May 12-14, 2004

Minerva Anestesiologica 2004 April;70(4):245-50

language: Italian

Administration of inhaled nitric oxide in newborns

Biban P.

Terapia Intensiva Neonatale e Pediatrica, Divisione di Pediatria, Ospedale Civile Maggiore, Azienda Ospedaliera di Verona, Verona


The use of inhaled nitric oxide (iNO) in newborn hypoxemic respiratory failure is based on the evidence of selective pulmonary vasodilation, without systemic side effects.
It is usedin more than 34 weeks old newborns, with severe acute pulmonary hypertension and right-left extrapulmonary shunt. In the other cases (i.e. pneumonia, sepsis, ARDS), the therapeutic effect is less evident; no final data are available on the use of iNO in pre-term babies.
The recommended dosage is 20 ppm, scaling down until 5 ppm and the 40 ppm should never be reached. The length of treatment is variable, usually no more than 7 days and the weaning should be progressive.
In conclusion,the use of iNO in newborns with persistent pulmonary hypertension reduces the need of ECMO, but does not substantially modify the outcome.

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