Inhaled nitric oxide in term and near-term infants: Neurodevelopmental follow-up of The Neonatal Inhaled Nitric Oxide Study Group (NINOS) Academic Article uri icon

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abstract

  • BACKGROUND: Inhaled nitric oxide (INO) improved oxygenation and reduced the occurrence of death or extracorporeal membrane oxygenation in term and near-term hypoxic neonates. We report the results of neurodevelopmental follow-up of infants enrolled in the NINOS trial. METHODS: Hypoxic infants >/=34 weeks' gestation and <14 days of age were randomized to 20 ppm INO or 100% oxygen as control. Comprehensive neurodevelopmental assessment of survivors occurred at 18 to 24 months of age. RESULTS: A total of 235 infants were enrolled in the original trial. There were 36 deaths, 20 of 121 infants in the control group and 16 of 114 infants in the INO-treated group. Of the 199 surviving infants, 173 (86.9%) were seen for follow-up (88 members of the control group and 85 members of the INO-treated group), and 135 infants were normal (69 [79.3%] members of the control group and 66 [77.6%] members of the INO-treated group). Twenty-two infants had sensorineural hearing loss (12 members of the control group and 10 members of the INO-treated group). Moderate to severe cerebral palsy occurred in 13 infants (7 infants in the control group and 6 infants in the INO-treated group). Mental developmental index scores (87 +/- 18.7 in the control group vs 85 +/- 21.7 in the INO-treated group) and psychomotor developmental index scores (93.6 +/- 17.5 in the control group vs 85.7 +/- 21.2 in the INO-treated group) were not different. A total of 29.6% of the control group compared with 34.5% of the INO-treated group had at least one disability. Infants with congenital diaphragmatic hernia, enrolled in a separate but parallel trial, had similar outcomes with a higher incidence of sensorineural hearing loss. CONCLUSION: Inhaled nitric oxide is not associated with an increase in neurodevelopmental, behavioral, or medical abnormalities at 2 years of age.

authors

  • Finer, NN
  • Vohr, BR
  • Robertson, CMT
  • Ehrenkranz, RA
  • Verter, J
  • Wright, LL
  • Hoffman, HJ
  • Walsh-Sukys, MC
  • Dusick, AM
  • Fleisher, BE
  • Steichen, J
  • Laadt, G
  • Yolton, K
  • Delaney-Black, V
  • Vohr, BR
  • Whitfield, MF
  • Blayney, MP
  • Sauve, RS
  • Casiro, OG
  • Saigal, Saroj
  • Riley, SP
  • Robertson, CMT
  • Sankaran, K
  • Gosselin, R
  • Reynolds, A
  • Stork, E
  • Gorjanc, E
  • Verter, J
  • Powers, T
  • Sokol, GM
  • Appel, D
  • Wright, LL
  • Van Meurs, K
  • Rhine, W
  • Ball, B
  • Brilli, R
  • Moles, L
  • Crowley, M
  • Backstrom, C
  • Crouse, D
  • Hudson, T
  • Konduri, GG
  • Bara, R
  • Kleinman, M
  • Hensmann, A
  • Rothstein, RW
  • Ehrenkranz, RA
  • Solimano, A
  • Germain, F
  • Walker, R
  • Ramirez, AM
  • Singhal, N
  • Bourcier, L
  • Fajardo, C
  • Cook, V
  • Kirpalani, Haresh
  • Monkman, S
  • Johnston, A
  • Mullahoo, K
  • Finer, NN
  • Peliowski, A
  • Etches, P
  • Kamstra, B
  • Sankaran, K
  • Riehl, A
  • Blanchard, P
  • Gouin, R
  • Wearden, ME
  • Gomez, MR
  • Moon, YS
  • Avery, GB
  • D'Alton, ME
  • Bracken, MB
  • Catz, C
  • Gleason, CA
  • Maguire, M
  • Redmond, CK
  • Sinclair, JC
  • Verter, J

publication date

  • May 2000

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