IN INFANTS WITH PERSISTENT PULMONARY HYPERTENSION, WHICH ONE OF THE FOLLOWING MEDICATIONS HAS BEEN DEMONSTRATED BY RANDOMIZED, CONTROLLED TRIALS TO REDUCE THE NEED FOR EXTRACORPOREAL MEMBRANE OXYGENATION
- A. Sodium bicarbonate
- B. Fentanyl (narcotic)
- C. Pancuronium (paralytic)
- D. Inhaled nitric oxide ✓
- E. Albuterol
In infants with persistent pulmonary hypertension, the medication that has been demonstrated by randomized, controlled trials to reduce the need for extracorporeal membrane oxygenation (ECMO) is D. Inhaled nitric oxide.
Persistent pulmonary hypertension of the newborn (PPHN) is a condition characterized by elevated pulmonary vascular resistance leading to right-to-left shunting of blood and hypoxemia. Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator that has been shown to improve oxygenation in infants with PPHN by dilating pulmonary vessels and improving ventilation-perfusion matching.
In other words, Inhaled nitric oxide is a selective pulmonary vasodilator that can help improve oxygenation and reduce the need for ECMO in infants with persistent pulmonary hypertension.
Several randomized controlled trials have demonstrated the efficacy of inhaled nitric oxide in reducing the need for ECMO in infants with PPHN. One landmark study published in the New England Journal of Medicine showed that iNO therapy significantly reduced the need for ECMO and improved survival without neurodevelopmental impairment at 2 years of age in infants with hypoxic respiratory failure associated with PPHN.
Therefore, based on the evidence from randomized controlled trials, inhaled nitric oxide is the medication of choice for reducing the need for ECMO in infants with persistent pulmonary hypertension.
