Clinical Programs
Inhaled Nitric Oxide
In late 1999, the US Food and Drug Administration approved nitric oxide for treatment of pulmonary hypertension in newborns 34 weeks' gestation and older. FDA approval was based on the results of several large, randomized, controlled trials that demonstrated that the use of inhaled nitric oxide in newborns with hypoxemic respiratory failure improves oxygenation and reduces the need for ECMO (heart-lung bypass). Baylor College of Medicine neonatologists participated in the first large trial, and our section treats more than 65 infants a year with inhaled nitric oxide.
iNO can produce pulmonary vasodilation in newborns with hypoxic respiratory failure. The etiologies of neonatal hypoxic respiratory failure that have been shown to respond to iNO include primary pulmonary hypertension, severe hyaline membrane disease, meconium aspiration, pneumonia, and sepsis.
Nitric oxide is considered a safe and effective alternative to ECMO in many circumstances, primarily because iNO is delivered non-invasively and easily through the ventilator circuit. However, immediate accessibility to an ECMO center must be considered when using iNO treatment since infants who do not respond to iNO may need to be quickly placed on ECMO. BCM physicians at Texas Children's Hospital have both options (iNO and ECMO) at their disposal.
