Abstract

SILVERA, Fernando et al. Pulmonary hypertension and several hypoxia of the newborn. Rev. bol. ped. [online]. 2009, vol.48, n.1, pp.54-66. ISSN 1024-0675.

Inhaled nitric oxide (iNO) through direct pulmonary vasodilator action and without sistemyc effects, is the gold standard treatment for pulmonary hypertension of the newborn (HTPP). This work was designed with the aim of evaluating the response to this treatment in 16 newborn patients in an intensive care unit, by changes in oxygen saturation (SO2), medium airway pressure (MAP) and inspirited fraction of O₂ (FiO₂). Two groups were anaylized: 1) under iNO treatment during the first 72 hs of life, where the most frequent diagnosis was meconium aspiration syndrom,e and 2) newborns with severe respiratory failure (n=3), refractary to treatment, in which iNO was begun after 14 days of life. Among patients of group 1 it was evident an increase in SO₂ after the irst 6 hs of treatment with iNO. The decrease FiO₂ and MAP occurred later. The mortality rate was 23% (2/13) in this group. In group 2 the SO₂ increased, leading to a decrease in ventilatory support in the irst 72 hours of treatment in one case. iNO doses were lesser than 20 ppm in 8/13 patients, there were neither platelet impairment, nor bleeding or metahemoglobinemia. There was no rebound effect after inishing iNO therapy from minimum doses (2 ppm). In this unit the inclusion of iNO treatment in HTPP or respiratory failure was associated with improvement in SO₂ and a decrease in ventilatory support, without adverse effects resulting in a beneit over the globally support therapy.

Keywords : Hypertension; pulmonary; nitric oxide; anoxemia; infant; newborn.

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