ABSTRACT 1766 The aim of this analysis was to determine if an acute improvement in oxygenation, defined as an increased PaO2 >20 Torr in response to I-NO (responder), predicted outcome

for term infants with PPHN. Patients (N=155) were part of the treatment arm of a previously reported, placebo-controlled, double-masked, multicenter clinical trial from 1994 to 1996.

Patients received I-NO (0,5,20, or 80 ppm) at a constant dose until failure or success criteria were met. Pretreatment with surfactant and concomitant high frequency ventilation were not

permitted. The primary endpoint for the original trial was the development of at least one PPHN major sequelae (death, ECMO, neurologic sequelae, or bronchopulmonary dysplasia). Secondary

while 61(53%) were not. There were no statistically significant differences between patients receiving I-NO (pooled doses) classified as responders versus non-responders with respect to the

primary endpoint including death and/or ECMO. Treatment failure occurred less frequently for responders versus non-responders (15% versus 36%, p=0.01). The TWOI was lower for responders

versus non-responders (-8.4 versus -2.0, p<0.01). There was no difference in response rate for PPHN patients by underlying disease, however the response rate was greater when the baseline

OI was <25 versus ≥25 (64% versus 29%, p<0.01). If a higher threshold of PaO2 is used as the definition of an acute responder (> 70 Torr increase, i.e. above the median PaO2 for

responders), there is still no statistical difference in outcome compared to non-responders. We conclude that, although acute responders to I-NO (based on a generally utilized definition)

have a more sustained improvement in oxygenation and less deterioration to severe hypoxemia, this response is not predictive of outcome and the need for ECMO when early treatment of PPHN is

started with I-NO and conventional ventilation. (funded by Ohmeda, PPD) AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Division of Neonatal-Perinatal Medicine, Schneider Children's

Hospital, The Long Island Campus for the Albert Einstein College of Medicine, New Hyde Park, NY D Davidson, E S Barefield-St John, J Kattwinkel, G Dudell, R Straube, J Rhines & C T Chang

Authors * D Davidson View author publications You can also search for this author inPubMed Google Scholar * E S Barefield-St John View author publications You can also search for this

author inPubMed Google Scholar * J Kattwinkel View author publications You can also search for this author inPubMed Google Scholar * G Dudell View author publications You can also search for

this author inPubMed Google Scholar * R Straube View author publications You can also search for this author inPubMed Google Scholar * J Rhines View author publications You can also search

for this author inPubMed Google Scholar * C T Chang View author publications You can also search for this author inPubMed Google Scholar CONSORTIA THE I-NO/PPHN STUDY GROUP RIGHTS AND

PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Davidson, D., Barefield-St John, E., Kattwinkel, J. _et al._ Acute Improvement in Oxygenation as a Predictor for

Successful, Early Treatment of Persistent Pulmonary Hypertension of the Newborn (PPHN) Using Inhaled Nitric Oxide (I-NO). _Pediatr Res_ 45, 300 (1999).

https://doi.org/10.1203/00006450-199904020-01783 Download citation * Issue Date: 01 April 1999 * DOI: https://doi.org/10.1203/00006450-199904020-01783 SHARE THIS ARTICLE Anyone you share the

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