Transient Defect in Nitric Oxide Generation after Rupture of Fetal Membranes and Responsiveness to Inhaled Nitric Oxide in Very Preterm Infants with Hypoxic Respiratory Failure
The Journal of Pediatrics,

Aikio O et al. – Seven percent of VLGA infants with preterm rupture of membranes and 15% of those with prolonged preterm rupture of membranes (PPROM) developed hypoxic respiratory failure (HRF), characterized by pulmonary hypertension that acutely responds to iNO. These infants may have a transient deficiency in the inflammatory response, including a defect in nitric oxide generation in airspaces.

Methods
  • Of a cohort of 765 VLGA infants, 144 required mechanical ventilation.
  • Airway specimens from these patients were prospectively studied.
  • Infants who developed HRF (oxygenation index >25) with echocardiographic diagnosis of pulmonary hypertension were treated with inhaled nitric oxide (iNO).
  • Three gestation comparison groups were formed on the basis of specific antenatal complications: prolonged preterm rupture of membranes (PPROM), spontaneous preterm birth, and preeclampsia.

Results
  • Seventeen (2.2% of all VLGA infants) developed HRF.
  • In all 17 cases, PPROM complicated the antenatal course; these infants responded to iNO, regardless of infection or PPROM.
  • The chest radiographs of HRF and non-HRF PPROM infants were similar.
  • Airway proinflammatory cytokines and nitrite + nitrate levels were low in infants with HRF, but they increased during iNO treatment and remained elevated after discontinuation of iNO.
  • Each of the 3 comparison groups had different and characteristic patterns of airway cytokines and nitrite + nitrate levels.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Medical Student

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Medical Student Articles

1 Midlife dietary vitamin D intake and subsequent performance in different cognitive domains Annals of Nutrition and Metabolism, September 16, 2014    Clinical Article

2 Regular fish consumption and age-related brain gray matter loss American Journal of Preventive Medicine, August 15, 2014    Clinical Article

3 Habitual intake of fruit juice predicts central blood pressure Appetite, October 24, 2014    Clinical Article

4 Oral bisphosphonate use and total knee/hip implant survival: Validation of results in an external population-based cohort Arthritis & Rheumatism, August 13, 2014    Clinical Article

5 Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk: Results from the EPIC cohort study International Journal of Cancer, October 3, 2014    Clinical Article

6 Effects of tea intake on blood pressure: A meta-analysis of 21 randomized controlled trials JACC - Journal of the American College of Cardiology, October 22, 2014    Clinical Article

7 Effect of ginger (Zingiber officinale) on heavy menstrual bleeding: a placebo-controlled, randomized clinical trial Phytotherapy Research, October 13, 2014    Clinical Article

8 Chocolate consumption and risk of heart failure in the Physicians Health Study European Journal of Heart Failure, October 17, 2014    Clinical Article

9 Intake of fruit and vegetables and risk of bladder cancer: A dose-response meta-analysis of observational studies Cancer Causes and Control, October 10, 2014    Clinical Article

10 Fish consumption and risk of rheumatoid arthritis: A dose-response meta-analysis Arthritis Research & Therapy, October 7, 2014    Evidence Based Medicine    Review Article

11 Trazodone improves sleep parameters in Alzheimer's disease patients: A randomized, double-blind, and placebo-controlled study The American Journal of Geriatric Psychiatry, October 15, 2014    Clinical Article

12 Serum 25-hydroxyvitamin D levels and metabolic health status in extremely obese individuals Obesity, October 10, 2014    Review Article

13 Effects of decontamination of the oropharynx and intestinal tract on antibiotic resistance in ICUs: a randomized clinical trial JAMA, October 10, 2014    Evidence Based Medicine    Clinical Article

14 Diet and inflammatory bowel disease: review of patient-targeted recommendations Clinical Gastroenterology and Hepatology , October 10, 2014    Review Article

15 Vitamin B12 and folate deficiency in chronic heart failure Heart, October 24, 2014    Clinical Article

16 Nutrition for the prevention and treatment of chronic kidney disease in diabetes Canadian Journal of Diabetes, September 26, 2014    Review Article

17 Effect of pentoxifylline on renal function and urinary albumin excretion in patients with diabetic kidney disease: The PREDIAN trial Journal of the American Society of Nephrology, June 30, 2014    Clinical Article

18 Vancomycin-resistant enterococci colonization among dialysis patients: A meta-analysis of prevalence, risk factors, and significance American Journal of Kidney Diseases, July 18, 2014    Review Article

19 Vitamin D analogue therapy, cardiovascular risk and kidney function in people with Type 1 diabetes mellitus and diabetic nephropathy: a randomized trial Diabetic Medicine, October 13, 2014    Clinical Article

20 Age-related cataract in men in the selenium and vitamin E cancer prevention trial eye endpoints study: A randomized clinical trial JAMA Ophthalmology, October 3, 2014    Evidence Based Medicine    Clinical Article

Indexed Journals in Medical Student: Academic Medicine, BMC Medical Education, Medical Teachermore