The clinical effects of combined use of inhaled nitric oxide at early stage to cure severe respiratory failure in neonates

OBJECTIVE: To observe the clinical effects of combined use of inhaled nitric oxide at the early stage to cure severe respiratory failure in neonates.

PATIENTS AND METHODS: 45 cases of neonates with severe respiratory failure, who were admitted to the neonatal intensive care unit (NICU) of XuZhou Children's Hospital from November 2014 to February 2016, were selected as objects of study, namely the iNO treatment group. On the basis of conventional treatment and mechanical ventilation, all of them were treated with the combined use of iNO at the early stage. The arterial blood gas index, respiratory function index and other indexes of those children were observed before iNO treatment and 1 h, 6 h, 12 h and 24 h post-treatment. 31 cases of newborns with severe respiratory failure admitted to the NICU of the same hospital from July 2013 to August 2014 were analyzed and selected as the control group. The cases in this group met the same criteria as those administered the iNO treatment. Comparisons were made between both groups in terms of the duration of ventilator support, complications during treatment, oxygen supply time, hospital stay and other data.

RESULTS: When treated after 1 h, 6 h, 12 h and 24 h, the pH value, arterial oxygen and carbon dioxide partial pressure of children in the iNO inhalation group significantly improved compared to those before treatment, and the difference was significant (p<0.05). When treated after 6, 12 and 24 h, the inspired oxygen concentration and oxygenation values of children significantly decreased compared to before treatment (p<0.05). When treated after 6, 12, and 24 h, the mean airway pressure of children was less than that before treatment and the difference was statistically significant (p<0.05). When treated after 1 h, 6, 12, 24 h, the arterial alveolar oxygen partial pressure ratio of children was greater than that before treatment and the difference was significant (p<0.05). When treated after 24 h, the pulmonary artery pressure of children significantly decreased compared to before treatment (p<0.05). Compared to the control group, the complications during the treatment, the respirator use time, oxygen supply time, length of stay and the mortality of children in the iNO treatment group were significantly decreased.

CONCLUSIONS: Mechanical ventilation, combined with iNO therapy, can effectively improve the respiratory function and arterial blood gas index of neonates with severe respiratory failure, improve the oxygenation, reduce complications and improve the quality of rescue, which is worthy of promotion.

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