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NeoReviews Vol.8 No.6 2007 e247
© 2007 American Academy of Pediatrics

Pharmacology Review

Use of Inhaled Nitric Oxide in the Preterm Infant

Robin H. Steinhorn, MD^*
John P. Kinsella, MD

^* Children's Memorial Hospital and Northwestern University, Chicago, Ill
The Children's Hospital and University of Colorado School of Medicine, Denver, Colo

Studies have shown that inhaled nitric oxide (iNO) improves ventilation/perfusion matching, decreases lung inflammation and oxidant stress, and restores more normal patterns of angiogenesis and parenchymal growth in the immature lung. Such findings suggest a potential role for this therapy in preterm newborns at risk for bronchopulmonary dysplasia. Early clinical trials have shown that iNO can benefit larger preterm infants (>1,000 g) who have early respiratory failure and preterm infants who continue to require positive pressure support after the first postnatal week. Debate continues as to whether iNO increases the rate of intracerebral hemorrhage. Additional trials are needed to discern benefits to specific forms and durations of iNO therapy in both the short and long term.