Neurodevelopmental and medical outcomes of persistent pulmonary hypertension in term newborns treated with nitric oxide

J Pediatr. 2002 Mar;140(3):306-10. doi: 10.1067/mpd.2002.122730.

Abstract

Objective: To determine the medical and neurodevelopmental outcome of children with moderately severe persistent pulmonary hypertension of the newborn (PPHN) treated with or without inhaled nitric oxide (I-NO).

Study design: Term infants with PPHN and a baseline oxygenation index of 24 +/- 9 at study entry were randomly assigned to early treatment with placebo or initial doses of I-NO (5, 20, and 80 ppm). Outcome was measured at approximately 1 year by frequency of hospitalization, growth, and neurodevelopmental and audiologic evaluation.

Results: Of 155 children enrolled, 144 survived, and there was follow-up for 133. No significant differences between the placebo and the I-NO groups were seen in any long-term outcome. Rehospitalization occurred in 22%, and growth did not differ. The composite neurodevelopment and audiologic outcome showed impairment in 46% of the infants. There were major neurologic abnormalities in 13%, cognitive delays in 30%, and hearing loss in 19% of the infants.

Conclusions: Moderately severe PPHN at 24 hours after birth is associated with high rates of rehospitalization and disability at 1 year. Adverse outcomes were the same in I-NO and control groups.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Cognition Disorders / etiology
  • Developmental Disabilities / etiology*
  • Developmental Disabilities / prevention & control
  • Hearing Loss, Sensorineural / etiology
  • Hearing Loss, Sensorineural / prevention & control
  • Humans
  • Infant, Newborn
  • Nervous System Diseases / etiology*
  • Nervous System Diseases / prevention & control
  • Nitric Oxide / administration & dosage*
  • Nitric Oxide / adverse effects
  • Persistent Fetal Circulation Syndrome / complications*
  • Persistent Fetal Circulation Syndrome / therapy*
  • Treatment Outcome
  • Vasodilator Agents / administration & dosage*
  • Vasodilator Agents / adverse effects
  • Weight Gain

Substances

  • Vasodilator Agents
  • Nitric Oxide