NO use in the preterm

Article Outline

• Copyright

In this issue of The Journal, Hintz et al report that very ill preterm infants randomized to nitric oxide (NO) had no improvement in neurodevelopment outcomes relative to controls. This result differs from the improvements in short-term indicators of brain injury or neurodevelopment for less ill cohorts of infants as reviewed by Kinsella and Abman in this issue. This comprehensive review highlights the different populations and study designs used to evaluate NO therapy for preterms. The effect of NO on oxygenation, the surrogate clinical indicator of pulmonary hypertension, has not been consistent or impressive in the preterm. Thus, any benefits from NO therapy may result from other effects of NO. The long-term neurodevelopmental outcomes for the infants enrolled in the recently completed trials will be important to a decision about the indications for NO in preterms.