Title

Inhaled Nitric Oxide Is Associated with Improved Oxygenation in a Subpopulation of Infants with Congenital Diaphragmatic Hernia and Pulmonary Hypertension.

Authors

Kendall M Lawrence, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Stylianos Monos, Children's Hospital of Philadelphia, Philadelphia, PA
Samantha Adams, Children's Hospital of Philadelphia, Philadelphia, PA
Lisa M Herkert, Children's Hospital of Philadelphia, Philadelphia, PAFollow
William H Peranteau, Children's Hospital of Philadelphia, Philadelphia, PAFollow
David Munson, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Rachel K Hopper
Catherine M Avitabile, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Natalie E Rintoul, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Holly L Hedrick, Children's Hospital of Philadelphia, Philadelphia, PAFollow

Publication Title

The Journal of pediatrics

Document Type

Article

PubMed ID

31706636

Abstract

OBJECTIVES: To determine which patients with congenital diaphragmatic hernia (CDH) and pulmonary hypertension (PH) benefit from inhaled nitric oxide (iNO) treatment by comparing characteristics and outcomes of iNO responders to nonresponders.

STUDY DESIGN: We performed a retrospective chart review of infants with CDH treated at our center between 2011 and 2016. In a subset of patients, iNO was initiated for hypoxemia or echocardiographic evidence of extrapulmonary right to left shunting. Initial post-treatment blood gases were reviewed, and patients were classified as responders (increased PaO

RESULTS: During the study period, 95 of 131 patients with CDH (73%) were treated with iNO. All patients with pretreatment echocardiograms (n = 90) had echocardiographic evidence of PH. Thirty-eight (40%) patients met treatment response criteria. Responders had significant improvements in PaO

CONCLUSIONS: iNO treatment is associated with improved oxygenation and reduced need for ECMO in a subpopulation of patients with CDH with PH and normal left ventricular systolic function.

Keywords

Administration, Inhalation, Female, Hernias, Diaphragmatic, Congenital, Humans, Hypertension, Pulmonary, Infant, Male, Nitric Oxide, Oxygen, Retrospective Studies, Treatment Outcome

DOI

10.1016/j.jpeds.2019.09.052

Publication Date

4-1-2020

Citation

Lawrence, K., Monos, S., Adams, S., Herkert, L., Peranteau, W., Munson, D., Hopper, R., Avitabile, C., Rintoul, N., & Hedrick, H. (2020). Inhaled Nitric Oxide Is Associated with Improved Oxygenation in a Subpopulation of Infants with Congenital Diaphragmatic Hernia and Pulmonary Hypertension.. The Journal of pediatrics, 219, 167-172. https://doi.org/10.1016/j.jpeds.2019.09.052