Hypoxic respiratory failure is a potentially fatal condition in which newborn infants, for a variety of reasons, cannot breathe in enough oxygen to survive. As a result of this procedure, one of the carotid arteries, which carries blood to the right side of the brain, is often permanently lost. ECMO is expensive, requires constant monitoring, and is associated with a nearly 20 percent rate of neurologic abnormalities. Of the 1,000 newborns in the U.S. who are treated with ECMO each year, approximately 82 percent survive. Dr. Wright added that the nitric oxide therapy could not only benefit the approximately 1,000 infants who undergo ECMO each year, but could also benefit an estimated 2 to 3 times as many children.
Nitric oxide relaxes the blood vessels that line the lung, allowing it to absorb more oxygen.
Unlike other treatments that expand the blood vessels in the lung, nitric oxide does not decrease blood pressure elsewhere in the body. Because hypoxic respiratory failure is an uncommon disease in newborns, previous studies that have attempted to prove that nitric oxide reduces the incidence of death or the need for ECMO have failed because they have been unable to enroll enough infants to assess the impact of nitric oxide on these important outcomes. Established in 1986, the Neonatal Research Network is a national network of 14 tertiary neonatal centers which conduct multi-center trials in neonatology, focusing specifically on the optimal management and care of infants in neonatal intensive care units.