ABSTRACT

Inhaled nitric oxide improves oxygenation, lessens the need for further treatment modalities, and is especially useful in persistent pulmonary hypertension in term newborns with hypoxemic respiratory failure. The role of inhaled nitric oxide in premature newborns with hypoxemic respiratory failure is controversial as far as its efficacy is concerned, although a few studies have demonstrated acute improvement in oxygenation in premature newborns with respiratory distress syndrome.

An 8-day old 26 weeks' gestation premature newborn with severe hypoxemic respiratory failure (oxygenation index >30 and mean airway pressure= 14 cmH2O) unresponsive to conventional mechanical ventilation and high frequency oscillatory ventilation was treated with a 6-day-course of inhaled nitric oxide (10-30 ppm). Oxygenation improved, the patient responded well, and she was extubated on the 28th day of life.

Low-dose inhaled nitric oxide improved oxygenation and treated severe hypoxemic respiratory failure in the present case. Inhaled nitric oxide should, therefore, be considered as one of the rescue treatments of severe hypoxemic respiratory failure in premature newborns.