Abstract

LUSTEMBERG, Antonio; BLASINA, Fernanda; SILVERA, Fernando  and  VAAMONDE, Lucía. Inhaled nitric oxide in the treatment of early respiratory failure in the late preterm and early term newborn: Report of two cases. Arch. Pediatr. Urug. [online]. 2016, vol.87, n.4, pp.351-358. ISSN 0004-0584.

Failure in transition from fetal to neonatal circulation can be caused by the persistence of elevated vascular resistance, which can lead to pulmonary hypertension syndrome (HPPN), occuring in approximately 2 out of 1,000 live newborns. Severe HPPN is associated with term or near term newborns, although it may be seen in preterms. The gold standard treatment is inhaled nitric oxide (NOi) in neonates with hypoxic respiratory failure and HPPN. In the Department of Neonatology of the University Hospital in Montevideo, a portable, in situ generator of nitric oxide-NO- (TAS+plus®) was used, which is capable to continuously produce the gas to be delivered to the newborn. Its low cost and accessibility have expanded its indications to patients with mechanical ventilation (MVA), continuous positive airway pressure through nasal cannula (nasal CPAP) or cephalic carp. We present two patients with respiratory distress, in whom, once the structural congenital heart disease and echocardiographic evidence of HPPN were discarted, NOi was administered, concomitant with nasal CPAP, in order to avoid the progression of respiratory disease and AVM. These patients of 32 and 37 weeks presented good evolution of their respiratory difficulty. The improvement of hypoxic respiratory failure through the administration of NOi, without the need for invasive ventilation, was possible, low cost and easy to apply to patients, incorporating the use of a novel ONi generator in clinical practice.

Keywords : NITRIC OXIDE; RESPIRATORY DISTRESS SYNDROME; PULMONARY HYPERTENSION; NEWBORN.

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