Inhaled Nitric Oxide (iNO) in Newborns *EXPLAINED*
What is Inhaled Nitric Oxide (iNO)? We created this video to cover the medical definition and provide a brief overview of this topic.
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➡️ Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator that has been studied and utilized for a variety of respiratory conditions.
-- Persistent Pulmonary Hypertension of the Newborn (PPHN)
INO has been approved by the FDA for treating PPHN in neonates. It helps to reduce the need for extracorporeal membrane oxygenation (ECMO) by improving oxygenation and reducing pulmonary vascular resistance in affected infants.
-- Acute Respiratory Distress Syndrome (ARDS)
Although not FDA-approved for this indication, iNO has been used off-label for treating ARDS in both adults and children. It may help to improve oxygenation and reduce the need for mechanical ventilation in these patients.
-- Pulmonary Hypertension
INO has been investigated as a potential treatment for various forms of pulmonary hypertension, including chronic thromboembolic pulmonary hypertension (CTEPH) and pulmonary arterial hypertension.
Studies have shown that INO may improve exercise capacity and hemodynamics in these patients. INO is not routinely used in the management of respiratory failure associated with prematurity. INO can be administered in newborns with mechanical ventilation by using a specially designed system that is capable of precision drug dosing. The recommended dose for INO is 20 ppm.
When a desired outcome has been achieved, the INO dose is gradually titrated by 50% increments to reach a final dose of 1 ppm. Then the drug is discontinued. The patient may experience a rebound effect and withdrawal symptoms, which can be mitigated by increasing the delivered FiO2. INO should be accessible in every hospital with a level III intensive care nursery, and it should also be integrated into high-risk transport teams. Non-ECMO centers should have a treatment failure plan that takes into consideration the distance to the nearest ECMO center. Inhaled nitric oxide (iNO) is an important gas for treating newborns who require mechanical ventilation for hypoxemic respiratory failure.
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🚑MEDICAL DISCLAIMER
This content is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please consult with a physician with any questions that you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you watch in this video. We strive for 100% accuracy, but errors may occur, and medications, protocols, and treatment methods may change over time.
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⏰TIMESTAMPS
0:00 - Intro
0:24 - Inhaled Nitric Oxide (iNO)
0:35 - Persistent Pulmonary Hypertension of the Newborn (PPHN)
1:01 - Acute Respiratory Distress Syndrome (ARDS)
1:23 - Pulmonary Hypertension
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