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Changes in arterial oxygen tension when weaning neonates from inhaled nitric oxide * †
Author(s) -
Sokol Gregory M.,
Fineberg Naomi S.,
Wright Linda L.,
Ehrenkranz Richard A.
Publication year - 2001
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1083
Subject(s) - medicine , weaning , arterial oxygen tension , oxygenation , anesthesia , nitric oxide , oxygen tension , pulmonary surfactant , oxygen , lung , biochemistry , biology , chemistry , organic chemistry
We set out to evaluate changes in arterial oxygen tension (PaO 2 ) when weaning neonates from inhaled nitric oxide (INO). We reviewed the records of 505 prospectively collected INO weaning attempts on 84 neonates with hypoxic respiratory failure. PaO 2 values before and 30 min after weaning attempts were recorded. Relationships between change in PaO 2 and decreases in INO concentrations were investigated using regression analysis and ANOVA. PaO 2 decreased (−18.7 ± 1.8 torr; P < 0.001); when weaning INO. A stepwise decline in PaO 2 was observed weaning INO from 40 ppm. The greatest decline occurred when INO was discontinued (−42.1 ± 4.1 torr). Forward stepwise multiple regression using variables with significant relationships to the decline in PaO 2 identified the specific dose reduction 7( P < 0.001), the prewean PaO 2 ( P < 0.001), and surfactant therapy ( P = 0.018) as the variables best describing the change in PaO 2 ( P = 0.004, r = 0.51). In conclusion, a graded decline in PaO 2 occurs when reducing INO. INO should be weaned to less than 1 ppm before discontinuing its use. Prior surfactant treatment appears to enhance the oxygenation reserve when weaning INO. Pediatr Pulmonol. 2001; 32:14–19. © 2001 Wiley‐Liss,Inc.