@article {BaczynskiF508, author = {Michelle Baczynski and Shannon Ginty and Dany E Weisz and Patrick J McNamara and Edmond Kelly and Prakeshkumar Shah and Amish Jain}, title = {Short-term and long-term outcomes of preterm neonates with acute severe pulmonary hypertension following rescue treatment with inhaled nitric oxide}, volume = {102}, number = {6}, pages = {F508--F514}, year = {2017}, doi = {10.1136/archdischild-2016-312409}, publisher = {BMJ Publishing Group}, abstract = {Objective To describe short-term and long-term outcomes of preterm neonates with severe acute pulmonary hypertension (aPHT) in relation to response to rescue inhaled nitric oxide (iNO) therapy.Design Retrospective cohort studyover a 6 year period.Setting Tertiary neonatal intensive care unit.Patients 89 neonates \<35 weeks gestational age (GA) who received rescue iNO for aPHT, including 62 treated at <=3 days of age (early aPHT).Interventions iNO >= 1 hour.Main outcome measures Positive responders (reduction in fraction of inspired oxygen (FiO2) >=0.20 within 1 hour of iNO) were compared with non-responders. Primary outcome was survival without moderate-to-severe disability at 18 months of age.Results Mean (SD) GA and birth weight was 27.7 (3.0) weeks and 1077 (473) gm, respectively. Median (IQR) pre-iNO FiO2 was 1.0 (1.0, 1.0). Positive response rate to iNO was 46\%. Responders showed improved survival without disability (51\% vs 15\%; p\<0.01), lower mortality (34\% vs 71\%; p\<0.01) and disability among survivors (17\% vs 50\%; p=0.06). Higher GA (adjusted OR: 1.44 (95\% CI 1.10 to 1.89)), aPHT in context of preterm prolonged rupture of membranes (6.26 (95\% CI 1.44 to 27.20)) and positive response to rescue iNO (5.81 (95\% CI 1.29 to, 26.18)) were independently associated with the primary outcome. Compared with late cases (\>3 days of age), early aPHT had a higher response rate to iNO (61\% vs 11\%; p\<0.01) and lower mortality (43\% vs 78\%; p\<0.01).Conclusion A positive response to rescue iNO in preterm infants with aPHT is associated with survival benefit, which is not offset by long-term disability.}, issn = {1359-2998}, URL = {https://fn.bmj.com/content/102/6/F508}, eprint = {https://fn.bmj.com/content/102/6/F508.full.pdf}, journal = {Archives of Disease in Childhood - Fetal and Neonatal Edition} }