Inhaled nitric oxide protects premature infants' brains

Despite tremendous advances in neonatal intensive care, premature babies with underdeveloped lungs remain at risk for brain injury and delayed development. In the July 7, 2005, issue of the New England Journal of Medicine, researchers from the University of Chicago report that adding tiny amounts of nitric oxide to the oxygen given to these premature infants on a mechanical ventilator in the first week of hospitalization reduced by nearly half the number of children with abnormal mental development at age 2.

This study follows a 2003 report by the same group showing that inhaled nitric oxide decreased the risk of chronic lung disease, severe bleeding into the brain and death in premature infants with respiratory distress syndrome.

The latest study, which focused on the mental development of the same children when assessed by neurologists near their second birthday, found that only 24 percent of the children who received nitric oxide at birth had delayed mental development or a disability, such as blindness, cerebral palsy or hearing loss, compared to 46 percent of those who received standard treatment of oxygen with no nitric oxide.

"This is the first therapy for premature infants that has demonstrated a significant impact on brain development," said study director Michael Schreiber, M.D., professor of pediatrics at the University of Chicago. "Not only does nitric oxide extend life in a large group of premature infants, it also improves the quality of life for the children and their parents."

Premature birth is one of the leading causes of infant death and disability in the United States. An estimated 60,000 children a year are born early with lungs so underdeveloped that they need help to breathe. These children have a much greater risk for death and lifelong health problems, including brain injury and delayed development.

The researchers followed 138 children from the original study 70 patients from the control group an

Contact: Katie O'Boyle
University of Chicago Medical Center

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