Am J Perinatol 2019; 36(04): 360-365
DOI: 10.1055/s-0038-1668556
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Childhood Pulmonary Function, Exercise Capacity, and Exhaled Nitric Oxide Levels: Outcomes following Neonatal Treatment with Inhaled Nitric Oxide to Prevent Bronchopulmonary Dysplasia

Howard Kilbride
1   Department of Pediatrics, Children's Mercy Kansas City, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri
,
Hugo Escobar
1   Department of Pediatrics, Children's Mercy Kansas City, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri
,
Anne Holmes
1   Department of Pediatrics, Children's Mercy Kansas City, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri
,
Kelli Teson
1   Department of Pediatrics, Children's Mercy Kansas City, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri
,
William Truog
1   Department of Pediatrics, Children's Mercy Kansas City, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri
› Author Affiliations
Further Information

Publication History

10 May 2018

07 July 2018

Publication Date:
19 August 2018 (online)

Abstract

Objective The goal was to determine if inhaled nitric oxide (iNO) for 3 weeks during neonatal care of high-risk preterm infants was associated with improved pulmonary function and exercise capacity or altered exhaled nitric oxide (FeNO) levels in later childhood.

Study Design Thirty-four very preterm children previously enrolled in a randomized, neonatal trial of iNO to prevent chronic lung disease, were assessed in follow-up at 7 to 9 years of age, including pulmonary function testing (PFT), exercise testing, and measurement of FeNO.

Results There were no differences in PFTs or exercise capacity between iNO treated and controls. FeNO levels showed large interpatient variability but tended to be lower in the iNO treated.

Conclusion Findings indicate no overall differences in pulmonary function or exercise capacity for children who had neonatal iNO treatment compared with placebo.

 
  • References

  • 1 Van Marter LJ. Epidemiology of bronchopulmonary dysplasia. Semin Fetal Neonatal Med 2009; 14 (06) 358-366
  • 2 Beam KS, Aliaga S, Ahlfeld SK, Cohen-Wolkowiez M, Smith PB, Laughon MM. A systematic review of randomized controlled trials for the prevention of bronchopulmonary dysplasia in infants. J Perinatol 2014; 34 (09) 705-710
  • 3 Jensen EA, Foglia EE, Schmidt B. Evidence-based pharmacologic therapies for prevention of bronchopulmonary dysplasia: application of the grading of recommendations assessment, development, and evaluation methodology. Clin Perinatol 2015; 42 (04) 755-779
  • 4 Cole FS, Alleyne C, Barks JD. , et al. NIH Consensus Development Conference statement: inhaled nitric-oxide therapy for premature infants. Pediatrics 2011; 127 (02) 363-369
  • 5 Bland RD, Albertine KH, Carlton DP, MacRitchie AJ. Inhaled nitric oxide effects on lung structure and function in chronically ventilated preterm lambs. Am J Respir Crit Care Med 2005; 172 (07) 899-906
  • 6 Cotton RB, Sundell HW, Zeldin DC. , et al. Inhaled nitric oxide attenuates hyperoxic lung injury in lambs. Pediatr Res 2006; 59 (01) 142-146
  • 7 Barrington KJ, Finer N. Inhaled nitric oxide for respiratory failure in preterm infants. Cochrane Database Syst Rev 2010; 12 (12) CD000509
  • 8 Ballard RA, Truog WE, Cnaan A. , et al; NO CLD Study Group. Inhaled nitric oxide in preterm infants undergoing mechanical ventilation. N Engl J Med 2006; 355 (04) 343-353
  • 9 Hibbs AM, Walsh MC, Martin RJ. , et al. One-year respiratory outcomes of preterm infants enrolled in the Nitric Oxide (to prevent) Chronic Lung Disease trial. J Pediatr 2008; 153 (04) 525-529
  • 10 Walsh MC, Hibbs AM, Martin CR. , et al; NO CLD Study Group. Two-year neurodevelopmental outcomes of ventilated preterm infants treated with inhaled nitric oxide. J Pediatr 2010; 156 (04) 556-561
  • 11 Kilbride HW, Gelatt MC, Sabath RJ. Pulmonary function and exercise capacity for ELBW survivors in preadolescence: effect of neonatal chronic lung disease. J Pediatr 2003; 143 (04) 488-493
  • 12 Baraldi E, Filippone M, Trevisanuto D, Zanardo V, Zacchello F. Pulmonary function until two years of life in infants with bronchopulmonary dysplasia. Am J Respir Crit Care Med 1997; 155 (01) 149-155
  • 13 Lum S, Kirkby J, Welsh L, Marlow N, Hennessy E, Stocks J. Nature and severity of lung function abnormalities in extremely pre-term children at 11 years of age. Eur Respir J 2011; 37 (05) 1199-1207
  • 14 Vrijlandt EJ, Boezen HM, Gerritsen J, Stremmelaar EF, Duiverman EJ. Respiratory health in prematurely born preschool children with and without bronchopulmonary dysplasia. J Pediatr 2007; 150 (03) 256-261
  • 15 Mieskonen ST, Malmberg LP, Kari MA. , et al. Exhaled nitric oxide at school age in prematurely born infants with neonatal chronic lung disease. Pediatr Pulmonol 2002; 33 (05) 347-355
  • 16 Baraldi E, Bonetto G, Zacchello F, Filippone M. Low exhaled nitric oxide in school-age children with bronchopulmonary dysplasia and airflow limitation. Am J Respir Crit Care Med 2005; 171 (01) 68-72
  • 17 Goldman AP, Haworth SG, Macrae DJ. Does inhaled nitric oxide suppress endogenous nitric oxide production?. J Thorac Cardiovasc Surg 1996; 112 (02) 541-542
  • 18 American Thoracic Society; European Respiratory Society. ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Am J Respir Crit Care Med 2005; 171 (08) 912-930
  • 19 Dubois AB, Brody AW, Lewis DH, Burgess Jr BF. Oscillation mechanics of lungs and chest in man. J Appl Physiol 1956; 8 (06) 587-594
  • 20 Dencker M, Malmberg LP, Valind S. , et al. Reference values for respiratory system impedance by using impulse oscillometry in children aged 2-11 years. Clin Physiol Funct Imaging 2006; 26 (04) 247-250
  • 21 Askie LM, Davies LC, Schreiber MD, Hibbs AM, Ballard PL, Ballard RA. Race effects of inhaled nitric oxide in preterm infants: an individual participant data meta-analysis. J Pediatr 2018; 193: 34-39
  • 22 Doyle LW, Carse E, Adams AM, Ranganathan S, Opie G, Cheong JLY. ; Victorian Infant Collaborative Study Group. Ventilation in extremely preterm infants and respiratory function at 8 years. N Engl J Med 2017; 377 (04) 329-337
  • 23 Gough A, Linden M, Spence D, Patterson CC, Halliday HL, McGarvey LP. Impaired lung function and health status in adult survivors of bronchopulmonary dysplasia. Eur Respir J 2014; 43 (03) 808-816
  • 24 Welsh L, Kirkby J, Lum S. , et al; EPICure Study Group. The EPICure study: maximal exercise and physical activity in school children born extremely preterm. Thorax 2010; 65 (02) 165-172
  • 25 Malleske DT, Chorna O, Maitre NL. Pulmonary sequelae and functional limitations in children and adults with bronchopulmonary dysplasia. Paediatr Respir Rev 2018; 26: 55-59
  • 26 Gabriele C, Jaddoe VW, van Mastrigt E. , et al. Exhaled nitric oxide and the risk of wheezing in infancy: the Generation R Study. Eur Respir J 2012; 39 (03) 567-572
  • 27 Dweik RA, Boggs PB, Erzurum SC. , et al; American Thoracic Society Committee on Interpretation of Exhaled Nitric Oxide Levels (FENO) for Clinical Applications. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications. Am J Respir Crit Care Med 2011; 184 (05) 602-615