Methemoglobin and the response to inhaled nitric oxide in persistent pulmonary hypertension of the newborn

R. Dadiz, J. Nair, C. T. D'angio, R. M. Ryan, S. Lakshminrusimha

Research output: Contribution to journalArticle

Abstract

BACKGROUND: We aimed to investigate whether the change in methemoglobin levels (ΔMHb) predicts oxygenation response to inhaled nitric oxide (iNO) in persistent pulmonary hypertension of the newborn (PPHN) with lung disease, with or without pulmonary hypoplasia. METHODS: In this prospective observational study, infants were categorized based on ΔMHb and oxygenation response (ΔPaO2/FiO2) following iNO: ΔMHb ≤0 or ΔMHb>0, and ΔPaO2/FiO2<20mmHg (Non-responder) or≥20mmHg (Responder). ΔMHb levels were compared among infants with or without pulmonary hypoplasia. RESULTS: Among infants with pulmonary hypoplasia (n=28), ΔMHb was not associated with an oxygenation response to iNO or survival without ECMO. Among infants without hypoplasia (n=29), subjects with ΔMHb>0 following iNO (n=21) had a greater ΔPaO2/FiO2 (median, 64mmHg; IQR, 127; p<0.01) and 100% survival without extracorporeal membrane oxygenation (ECMO) when compared to infants with ΔMHb ≤0 (n=8; median 10mmHg; IQR, 33). CONCLUSIONS: PPHN secondary to lung disease without hypoplasia with increased ΔMHb following iNO was associated with better oxygenation response and survival without ECMO compared to subjects without an increase in MHb.

Original languageEnglish (US)
Pages (from-to)175-182
Number of pages8
JournalJournal of Neonatal-Perinatal Medicine
Volume13
Issue number2
DOIs
StatePublished - 2020

Keywords

  • Hypoxic respiratory failure
  • oxygenation
  • pulmonary hypertension
  • pulmonary hypoplasia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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