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Nitric oxide can prevent lung disease and death for premature infants

Low doses of inhaled nitric oxide can decrease the risk of chronic lung disease and death by nearly one-fourth in premature infants who have respiratory distress syndrome (RDS), report researchers from the University of Chicago in the Nov. 27, 2003, issue of the New England Journal of Medicine.

Nitric oxide also can cut the risk of severe bleeding into the brain and loss of brain tissue devastating complications of prematurity by almost half.

The combination of prematurity and RDS may be lethal despite aggressive treatment, including mechanical ventilation. Approximately 60,000 children are born each year in the United States weighing less than 1,500 grams (about 3.3 pounds). Many of those who survive suffer permanent lung damage, which can slow growth, increase susceptibility to infection and is associated with abnormal brain development.

In the study, 64 percent of infants who received standard therapy died or developed chronic lung disease, compared to only 49 percent of those who received standard therapy plus inhaled nitric oxide.

"Inhaled nitric oxide gives neonatologists a simple and effective tool to help protect premature infants," says Michael Schreiber, M.D., associate professor of pediatrics at the University of Chicago and director of the study. "Our data demonstrate that starting nitric oxide soon after birth in at-risk babies has few downsides and makes a major difference in their long-term health."

Adding small amounts of nitric oxide to oxygen for neonates requiring ventilation may soon become standard practice, Schreiber predicts, stressing the need to start treatment early. "Chronic lung disease often begins in utero," he says, "so if you're going to intervene, you need to start therapy as soon as possible."

Nitric oxide, a gas produced by the body and used to transmit chemical signals, was approved in 1999 by the Food and Drug Administration for use in full-term babies. Because it can rel
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Contact: Karyn Odway
kodway@uchospitals.edu
773-702-6241
University of Chicago Medical Center
26-Nov-2003


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