Inhaled nitric oxide in premature infants: effect on tracheal aspirate and plasma nitric oxide metabolites

Objective:inhaled nitric oxide (ino) is a potential new therapy for prevention of bronchopulmonary dysplasia and brain injury in premature infants. this study examined dose-related effects of ino on no metabolites as evidence of no delivery.study design:a subset of 102 premature infants in the no cld trial, receiving 24 days of ino (20 p.p.m. decreasing to 2 p.p.m.) or placebo, were analyzed. tracheal aspirate (ta) and plasma samples collected at enrollment and at intervals during study gas were analyzed for no metabolites.result:ino treatment increased no metabolites in ta at 20 and 10 p.p.m. (1.7- to 2.3-fold vs control) and in plasma at 20, 10, and 5 p.p.m. (1.6- to 2.3-fold). in post hoc analysis, treated infants with lower metabolite levels at entry had an improved clinical outcome.conclusion:ino causes dose-related increases in no metabolites in the circulation as well as lung fluid, as evidenced by ta analysis, showing no delivery to these compartments.