Inhaled nitric oxide use in neonates: Balancing what is evidence-based and what is physiologically sound

Abstract

Inhaled nitric oxide is a powerful therapeutic used in neonatology. Its use is evidenced-based for term and near-term infants with persistent pulmonary hypertension; however, it is frequently used off-label both in term and preterm babies. This article reviews the off-label uses of iNO in infants. Rationale is discussed for a selective application of iNO based on physiologically guided principles, and new research avenues are considered.

Keywords: Bronchopulmonary dysplasia; Neonate; Nitric oxide; Persistent pulmonary hypertension of the newborn; Pulmonary arterial hypertension; Respiratory failure.