To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Experimental Nitric Oxide Therapy Saves Lives of Newborns with Lung Disorders URL: http://www.pslgroup.com/dg/1F052.htm Doctor's Guide February 26, 1997
SAN FRANCISCO-- Feb. 26, 1997--Critically ill newborns unable to breathe properly because of dangerously high blood pressure in their lungs are being saved by an experimental new treatment using nitric oxide, a chemical produced naturally in the body. Two clinical trials whose results are being published today in The New England Journal of Medicine, found that a small amount of inhaled nitric oxide is a safe and effective treatment for these infants and reduces the need for more invasive surgical intervention. March of Dimes grantees John P. Kinsella, M.D., and Steven H. Abman, M.D., of Children's Hospital and the Department of Pediatrics at the University of Colorado Health Sciences Center in Denver, whose earlier work is mentioned in the NEJM articles, received support from the Foundation to study the vital role of nitric oxide in the regulation of blood flow in the lungs. Their work provides important insight into lung diseases that affect both term and premature infants, such as persistent pulmonary hypertension (PPHN) and respiratory distress syndrome (RDS). Dr. Kinsella was one of the first physicians in the country to treat newborns with PPHN by giving them inhaled nitric oxide. At birth, in response to the first minutes of breathing air, the blood vessels in the lungs normally relax and allow blood to flow through them. This makes it possible for the blood to exchange carbon dioxide, a waste product, for oxygen. However, when this adaptation fails for some reason and the pulmonary high blood pressure (hypertension) persists, newborns may die or suffer damage to the brain and other organs due to lack of oxygen in their blood or to the complications of lifesaving efforts. Kinsella became interested in nitric oxide because of its ability to cause the walls of blood vessels to relax. In a separate study involving more than 200 newborns, Kinsella and his colleagues found that low doses of inhaled nitric oxide markedly improved oxygenation in critically ill newborns with PPHN. Besides saving their lives, this therapy spared the infants from more risky and invasive treatments, cut their hospitalization time, and greatly reduced their treatment costs. Until now, the only effective treatment for severe respiratory failure in infants has been a surgical treatment called extracorporeal membrane oxygenation (ECMO), a highly invasive and expensive procedure that is associated with a nearly 20 percent rate of neurologic abnormalities. PPHN affects some 5,000 to 7,000 infants a year. It may be a contributory factor in severe RDS, and may help explain why a substantial percentage of babies with RDS who are treated with surfactant do not respond well. Surfactant helps the microscopic air sacs in the lungs inflate (ventilation), but does not help the vessels relax to permit blood flow (perfusion). A balance between ventilation and perfusion is necessary for proper breathing. Once nitric oxide was known mainly as a pollutant produced in auto exhaust fumes. Today, its potential as a powerful medical tool is rapidly emerging. Researchers have learned that nitric oxide plays an important role in many activities involving the heart, blood vessels, brain, and immune system. The first article, "Inhaled nitric oxide in full-term and nearly full-term infants with hypoxic respiratory failure," by the Neonatal Inhaled Nitric Oxide Study Group, was supported by the National Institute of Child Health and Human Development and the Canadian Medical Research Council. The second article, "Inhaled nitric oxide and persistent pulmonary hypertension of the newborn," by Jesse D. Roberts, M.D., Jeffrey R. Fineman, M.D., and colleagues of Nitric Oxide Study Group, was supported by the National Institutes of Health. Dr. Fineman, M.D., and colleagues of the Inhaled Nitric Oxide Study Group, were supported by the National Institutes of Health. Fineman has received March of Dimes support to study the role of nitric oxide in treating pulmonary hypertension caused by congenital heart defects. The March of Dimes is a national voluntary health agency whose mission is to improve the health of babies by preventing birth defects and infant mortality. Through its Campaign for Healthier Babies, the March of Dimes funds programs of research, community services, education and advocacy. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.