Journal of perinatology : official journal of the California Perinatal Association · 2009
Methemoglobin to cumulative nitric oxide ratio and response to inhaled nitric oxide in PPHN.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Pabalan M J, Nayak S P, Ryan R M, Kumar V H, Lakshminrusimha S
Аннотация
BACKGROUND: One-third of infants with persistent pulmonary hypertension of the newborn (PPHN) do not respond to inhaled nitric oxide (iNO). If iNO is not delivered to the pulmonary vasculature because of parenchymal lung disease, it cannot interact with hemoglobin to form methemoglobin (MHb).
OBJECTIVE: To study the correlation between oxygenation response to iNO in infants with PPHN secondary to parenchymal lung disease and initial MHb% to cumulative NO exposure (ppm x hours) ratio (MHb/SigmaNO).
STUDY DESIGN: Retrospective chart review of neonates with PPHN secondary to parenchymal lung disease treated with iNO comparing non-responders (PaO(2)/FiO(2) ratio<10 change with iNO) with responders (>or=10 change).
RESULT: Non-responders (n=16) had a PaO(2)/F(iO2) of 83+/-48 (mean+/-s.d.) and decreased to 74+/-44 after iNO. PaO(2)/FiO(2) increased from 70+/-48 to 151+/-63 with iNO among responders (n=36). The MHb/SigmaNO ratio was low (0.024+/-0.012) among non-responders compared with responders (0.07+/-0.053, P<0.005).
CONCLUSION: Inadequate oxygenation response to iNO is associated with lower MHb/SigmaNO, suggesting suboptimal delivery of iNO to the pulmonary vasculature.
OBJECTIVE: To study the correlation between oxygenation response to iNO in infants with PPHN secondary to parenchymal lung disease and initial MHb% to cumulative NO exposure (ppm x hours) ratio (MHb/SigmaNO).
STUDY DESIGN: Retrospective chart review of neonates with PPHN secondary to parenchymal lung disease treated with iNO comparing non-responders (PaO(2)/FiO(2) ratio<10 change with iNO) with responders (>or=10 change).
RESULT: Non-responders (n=16) had a PaO(2)/F(iO2) of 83+/-48 (mean+/-s.d.) and decreased to 74+/-44 after iNO. PaO(2)/FiO(2) increased from 70+/-48 to 151+/-63 with iNO among responders (n=36). The MHb/SigmaNO ratio was low (0.024+/-0.012) among non-responders compared with responders (0.07+/-0.053, P<0.005).
CONCLUSION: Inadequate oxygenation response to iNO is associated with lower MHb/SigmaNO, suggesting suboptimal delivery of iNO to the pulmonary vasculature.
Предметные рубрики MeSH
Administration, InhalationBlood Gas AnalysisCase-Control StudiesDose-Response Relationship, DrugDrug MonitoringHumansInfant, NewbornMeconium Aspiration SyndromeMethemoglobinNitric OxidePersistent Fetal Circulation SyndromePneumonia, AspirationRespiratory Distress Syndrome, NewbornRetrospective StudiesTreatment FailureVasodilator Agents