The role of nitric oxide in the treatment of neonatal pulmonary hypertension

Curr Opin Pediatr. 1996 Apr;8(2):118-25. doi: 10.1097/00008480-199604000-00006.


Nitric oxide production appears to be decreased in infants with persistent pulmonary hypertension (PPHN). Inhaled nitric oxide may improve oxygenation by two mechanisms: increased pulmonary blood flow and improved ventilation-perfusion matching. Nitric oxide inhalation has been tested in newborns with PPHN, congenital heart diseases, and bronchopulmonary dysplasia. We present a review of the articles concerning inhaled nitric oxide for infants with PPHN. Overall, 59% of the neonates had an initial improvement in oxygenation in response to nitric oxide inhalation. A sustained response was observed in 60% of the infants. Patients with extrapulmonary shunting, clear chest radiographs, and adequate lung volume seem to have a better response, whereas patients with congenital diaphragmatic hernia, severe sepsis, and alveolar capillary dysplasia are more likely to fail. To define the benefit-risk ratio, six prospective randomized trials are currently in progress.

Publication types

  • Review

MeSH terms

  • Animals
  • Bronchopulmonary Dysplasia / drug therapy
  • Heart Defects, Congenital / complications
  • Heart Defects, Congenital / physiopathology
  • Humans
  • Hypertension, Pulmonary / complications
  • Hypertension, Pulmonary / drug therapy*
  • Hypertension, Pulmonary / physiopathology
  • Infant, Newborn
  • Nitric Oxide / administration & dosage
  • Nitric Oxide / pharmacology
  • Nitric Oxide / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome


  • Nitric Oxide