Methemoglobin to cumulative nitric oxide ratio and response to inhaled nitric oxide in PPHN

M. J. Pabalan; S. P. Nayak; R. M. Ryan; V. H. Kumar; S. Lakshminrusimha

doi:10.1038/jp.2009.69

Methemoglobin to cumulative nitric oxide ratio and response to inhaled nitric oxide in PPHN

M. J. Pabalan, S. P. Nayak, R. M. Ryan, V. H. Kumar, S. Lakshminrusimha

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Background: One-third of infants with persistent pulmonary hypertension of the newborn (PPHN) do not respond to inhaled nitric oxide (iNO). If iNO is not delivered to the pulmonary vasculature because of parenchymal lung disease, it cannot interact with hemoglobin to form methemoglobin (MHb). Objective: To study the correlation between oxygenation response to iNO in infants with PPHN secondary to parenchymal lung disease and initial MHb% to cumulative NO exposure (ppm × hours) ratio (MHb/ΣNO). Study Design: Retrospective chart review of neonates with PPHN secondary to parenchymal lung disease treated with iNO comparing non-responders (PaO₂/FiO₂ ratio<10 change with iNO) with responders (≥10 change). Result: Non-responders (n=16) had a PaO₂/F_iO2 of 83±48 (mean ± s.d.) and decreased to 74 ± 44 after iNO. PaO₂/FiO₂ increased from 70 ± 48 to 151 ± 63 with iNO among responders (n=36). The MHb/ΣNO ratio was low (0.024 ± 0.012) among non-responders compared with responders (0.07 ± 0.053, P<0.005). Conclusion: Inadequate oxygenation response to iNO is associated with lower MHb/ΣNO, suggesting suboptimal delivery of iNO to the pulmonary vasculature.

Original language	English (US)
Pages (from-to)	698-701
Number of pages	4
Journal	Journal of Perinatology
Volume	29
Issue number	10
DOIs	https://doi.org/10.1038/jp.2009.69
State	Published - 2009
Externally published	Yes

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynecology

Access to Document

10.1038/jp.2009.69

Cite this

@article{7dfc2f449c464dc29098229b7bb795d5,

title = "Methemoglobin to cumulative nitric oxide ratio and response to inhaled nitric oxide in PPHN",

abstract = "Background: One-third of infants with persistent pulmonary hypertension of the newborn (PPHN) do not respond to inhaled nitric oxide (iNO). If iNO is not delivered to the pulmonary vasculature because of parenchymal lung disease, it cannot interact with hemoglobin to form methemoglobin (MHb). Objective: To study the correlation between oxygenation response to iNO in infants with PPHN secondary to parenchymal lung disease and initial MHb% to cumulative NO exposure (ppm × hours) ratio (MHb/ΣNO). Study Design: Retrospective chart review of neonates with PPHN secondary to parenchymal lung disease treated with iNO comparing non-responders (PaO2/FiO2 ratio<10 change with iNO) with responders (≥10 change). Result: Non-responders (n=16) had a PaO2/FiO2 of 83±48 (mean ± s.d.) and decreased to 74 ± 44 after iNO. PaO2/FiO2 increased from 70 ± 48 to 151 ± 63 with iNO among responders (n=36). The MHb/ΣNO ratio was low (0.024 ± 0.012) among non-responders compared with responders (0.07 ± 0.053, P<0.005). Conclusion: Inadequate oxygenation response to iNO is associated with lower MHb/ΣNO, suggesting suboptimal delivery of iNO to the pulmonary vasculature.",

author = "Pabalan, {M. J.} and Nayak, {S. P.} and Ryan, {R. M.} and Kumar, {V. H.} and S. Lakshminrusimha",

year = "2009",

doi = "10.1038/jp.2009.69",

language = "English (US)",

volume = "29",

pages = "698--701",

journal = "Journal of Perinatology",

issn = "0743-8346",

publisher = "Nature Publishing Group",

number = "10",

}

TY - JOUR

T1 - Methemoglobin to cumulative nitric oxide ratio and response to inhaled nitric oxide in PPHN

AU - Pabalan, M. J.

AU - Nayak, S. P.

AU - Ryan, R. M.

AU - Kumar, V. H.

AU - Lakshminrusimha, S.

PY - 2009

Y1 - 2009

N2 - Background: One-third of infants with persistent pulmonary hypertension of the newborn (PPHN) do not respond to inhaled nitric oxide (iNO). If iNO is not delivered to the pulmonary vasculature because of parenchymal lung disease, it cannot interact with hemoglobin to form methemoglobin (MHb). Objective: To study the correlation between oxygenation response to iNO in infants with PPHN secondary to parenchymal lung disease and initial MHb% to cumulative NO exposure (ppm × hours) ratio (MHb/ΣNO). Study Design: Retrospective chart review of neonates with PPHN secondary to parenchymal lung disease treated with iNO comparing non-responders (PaO2/FiO2 ratio<10 change with iNO) with responders (≥10 change). Result: Non-responders (n=16) had a PaO2/FiO2 of 83±48 (mean ± s.d.) and decreased to 74 ± 44 after iNO. PaO2/FiO2 increased from 70 ± 48 to 151 ± 63 with iNO among responders (n=36). The MHb/ΣNO ratio was low (0.024 ± 0.012) among non-responders compared with responders (0.07 ± 0.053, P<0.005). Conclusion: Inadequate oxygenation response to iNO is associated with lower MHb/ΣNO, suggesting suboptimal delivery of iNO to the pulmonary vasculature.

AB - Background: One-third of infants with persistent pulmonary hypertension of the newborn (PPHN) do not respond to inhaled nitric oxide (iNO). If iNO is not delivered to the pulmonary vasculature because of parenchymal lung disease, it cannot interact with hemoglobin to form methemoglobin (MHb). Objective: To study the correlation between oxygenation response to iNO in infants with PPHN secondary to parenchymal lung disease and initial MHb% to cumulative NO exposure (ppm × hours) ratio (MHb/ΣNO). Study Design: Retrospective chart review of neonates with PPHN secondary to parenchymal lung disease treated with iNO comparing non-responders (PaO2/FiO2 ratio<10 change with iNO) with responders (≥10 change). Result: Non-responders (n=16) had a PaO2/FiO2 of 83±48 (mean ± s.d.) and decreased to 74 ± 44 after iNO. PaO2/FiO2 increased from 70 ± 48 to 151 ± 63 with iNO among responders (n=36). The MHb/ΣNO ratio was low (0.024 ± 0.012) among non-responders compared with responders (0.07 ± 0.053, P<0.005). Conclusion: Inadequate oxygenation response to iNO is associated with lower MHb/ΣNO, suggesting suboptimal delivery of iNO to the pulmonary vasculature.

UR - http://www.scopus.com/inward/record.url?scp=70349792646&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70349792646&partnerID=8YFLogxK

U2 - 10.1038/jp.2009.69

DO - 10.1038/jp.2009.69

M3 - Article

C2 - 19554014

AN - SCOPUS:70349792646

SN - 0743-8346

VL - 29

SP - 698

EP - 701

JO - Journal of Perinatology

JF - Journal of Perinatology

IS - 10

ER -

Methemoglobin to cumulative nitric oxide ratio and response to inhaled nitric oxide in PPHN

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this