Óxido nítrico inhalado como rescate en insuficiencia respiratoria del recién nacido inmaduro

Inhaled nitric oxide (iNO) is indicated in near-term (> 34 weeks' gestation) and term newborns with hypoxemic respiratory failure and persistent pulmonary hypertension, decreasing the need for extracorporeal membrane xygenation support in at least 40 %. Currently the use of iNO has not been approved for premature neonates, and its therapeutic efficacy in this group remains controversial. However, it has been suggested that iNO may be helpful by improving oxygenation and reducing the need for aggressive mechanical ventilation in some cases of severe hypoxemic respiratory failure in preterm infants with inadequate response to conventional treatment. We report the cases of three hypoxemic preterm neonates unresponsive to conventional treatment in whom the use of iNO was effective in the management of hypoxemic respiratory failure.