Non-invasive use of inhaled nitric oxide for neonatal pulmonary hypertension

Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator used as primary treatment for babies with persistent pulmonary hypertension of the newborn (PPHN). Evidence shows that its use reduces mortality and need for extracorporeal membrane oxygenation (ECMO).¹ iNO is normally commenced at a concentration of 20 parts per million (ppm) when babies have been intubated and ventilated and then slowly weaned off prior to extubation.

Dr Peter Reynolds
Consultant Neonatologist

Gemma Finch
Advanced Neonatal Nurse Practitioner

St Peter’s Hospital, Chertsey
peter.reynolds1@nhs.net
@neonataldoc

Reynolds P., Finch G. Non-invasive use of inhaled nitric oxide for neonatal pulmonary hypertension. Infant 2025; 21(1): 6-7.

Full text available by subscription ...

The full text of this article is available to subscribers in text, and in Tablet/iPad format and as a PDF file.

Please subscribe and log in to see the full article.

Keywords

inhaled nitric oxide; intubation; ventilation; non-invasive ventilation; persistent pulmonary hypertension of the newborn; pulmonary vasodilator

Key points

Minimisation of exposure to invasive ventilation is important.
Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator used as primary treatment for babies with PPHN.
Inhaled nitric oxide is used as primary treatment for babies with persistent pulmonary hypertension of the newborn.
iNO can be given via non-invasive ventilation in certain scenarios.

Also published in Infant:

VOLUME 15/ISSUE 3, MAY 2019

Airway management in neonatal intensive care units: the PIC-NIC survey

Improvements in airway management have occurred in almost all UK adult intensive care units following the publication of the Fourth National Audit Project (NAP4) in 2011. Subsequently the PIC-NIC survey investigated whether the lessons learned from NAP4 had filtered into paediatric practice. This article highlights the relevant findings for neonatal healthcare professionals by discussing the high-risk nature of neonatal airway management and strategies that might be used to improve safety including planning for difficulty, immediate access to emergency airway equipment and the role of continuous waveform capnography and videolaryngoscopy.