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	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Editorial by Stark, A. R. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Bronchopulmonary dysplasia in premature infants is associated with prolonged hospitalization, as well as abnormal pulmonary and neurodevelopmental outcome. In animal models, inhaled nitric oxide improves both gas exchange and lung structural development, but the use of this therapy in infants at risk for bronchopulmonary dysplasia is controversial.

Methods We conducted a randomized, stratified, double-blind, placebo-controlled trial of inhaled nitric oxide at 21 centers involving infants with a birth weight of 1250 g or less who required ventilatory support between 7 and 21 days of age. Treated infants received decreasing concentrations of nitric oxide, beginning at 20 ppm, for a minimum of 24 days. The primary outcome was survival without bronchopulmonary dysplasia at 36 weeks of postmenstrual age.

Results Among 294 infants receiving nitric oxide and 288 receiving placebo birth weight (766 g and 759 g, respectively), gestational age (26 weeks in both groups), and other characteristics were similar. The rate of survival without bronchopulmonary dysplasia at 36 weeks of postmenstrual age was 43.9 percent in the group receiving nitric oxide and 36.8 percent in the placebo group (P=0.042). The infants who received inhaled nitric oxide were discharged sooner (P=0.04) and received supplemental oxygen therapy for a shorter time (P=0.006). There were no short-term safety concerns.

Conclusions Inhaled nitric oxide therapy improves the pulmonary outcome for premature infants who are at risk for bronchopulmonary dysplasia when it is started between 7 and 21 days of age and has no apparent short-term adverse effects. (ClinicalTrials.gov number, NCT00000548 [ClinicalTrials.gov] .)

Source Information

From Children's Hospital of Philadelphia (R.A.B., A.C., P.L.B., A.M.H., X.L., S.R.W., C.E.C.) and the University of Pennsylvania School of Medicine (J.D.M.) — both in Philadelphia; the University of Missouri, Kansas City (W.E.T.); Case Western Reserve University, Cleveland (R.J.M., M.C.W.); Children's Hospital and Research Center, Oakland, Calif. (D.J.D., J.M.A.); the University of Washington School of Medicine, Seattle (D.E.M.); Harvard Medical School, Boston (E.C.E.); the University of Utah Medical Center, Salt Lake City (D.R.N.); the University of Florida Health Science Center, Jacksonville (M.L.H.); the University of California Los Angeles School of Medicine, Los Angeles (A.R.P.); New York Medical College, Valhalla (S.G.G.); Long Island Jewish Health System, New Hyde Park, N.Y. (S.E.C.); the University of Louisville School of Medicine, Louisville, Ky. (D.L.S.); Ohio State University School of Medicine and Public Health, Columbus (S.E.W.); and the University of California at San Francisco, San Francisco (R.H.P.).

Address reprint requests to Dr. Ballard at Children's Hospital of Philadelphia, 3535 Market St., Suite 1584, Philadelphia, PA 19104, or at ballard{at}email.chop.edu.

Full Text of this Article

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Inhaled Nitric Oxide in Preterm Infants — Correction
Ballard R. A.
Extract | Full Text | PDF  
N Engl J Med 2007; 357:1444-1445, Oct 4, 2007. Correspondence

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