INHALED NITRIC-OXIDE FOR A SEVERE RESPIRATORY SYNCYTIAL VIRUS-INFECTION IN AN INFANT WITH BRONCHOPULMONARY DYSPLASIA

Objective: To report the first case of ARDS in children treated with n itric oxide (NO) inhalation. Methods: A 13-months infant presented wit h BPD and severe hypoxemia related to RSV infection and ARDS. Inhaled NO was delivered in the ventilatory circuit of a continuous flow venti lator (Babylog 8000, Drager) in a concentration of 20-80 ppm for 7 day s. NO and NO2 were continuously monitored (Polyton Draeger). Respirato ry mechanics were evaluated by using the method of passive inflation b y the ventilator. Results: NO inhalation improved oxygenation (tcSaO(2 )) and reduced respiratory system resistance without affecting arteria l pressure. NO2 level remained below 5 ppm, and methaemoglobin level b elow 1%. The child survived without neurologic sequela. Conclusions: T wo mechanisms to explain oxygenation improvement can be suggested: sel ective improvement in perfusion of ventilated regions and bronchodilat ion.