The purpose of this pilot study is to evaluate whether administration of nitric oxide
(NO)gas by oxygen hood at 20 ppm significantly increases PaO2, as compared to placebo gas
(oxygen), within one hour of initiation and with no significant adverse effects.
It is possible that administration of inhaled NO to neonates with abnormal gas exchange
earlier, rather than later as a rescue therapy in a moribund state, might accelerate the
transition of the circulation from the fetal to neonatal physiology and improve oxygenation.
This may in turn decrease the need for mechanical ventilation, its associated morbidity and
perhaps even ECMO.
This study is designed as a pilot study to evaluate the physiologic efficacy (rather than
effect on clinical outcomes) of NO administered by hood in improving oxygenation of neonates
with elevated A-a DO2.
- Gestational age >34 completed weeks (>=35)
- Age <48 hours
- A-a DO2 400 to 600, on two post-ductal arterial blood gases one hour apart, while on
100% O2 by oxygen hood
- Post-ductal arterial access
- Admitted to The University of Alabama Birmingham Regional NICU
- Cardiac disease (structural disease with right to left or mixing lesions), not
including patent ductus arteriosus (PDA) or patent foramen ovale (PFO)
- Rapid deterioration requiring mechanical ventilation before entry into the study
- Major malformations
- Major neurologic or metabolic disorder or other illness leading to hypoventilation