Treatment of respiratory failure with inhaled nitric oxide and high-frequency ventilation in an infant with respiratory syncytial virus pneumonia andbronchopulmonary dysplasia

In a 7-month-old infant with bronchopulmonary dysplasia and respiratory syn cytial virus (RSV) pneumonia, we have shown an additive effect of high-freq uency ventilation (HFV) and inhaled nitric oxide (iNO) in terms of improved oxygenation and the avoidance of extracorporeal membrane oxygenation. Appa rently, the combined therapy of HFV and iNO is superior to either therapeut ic modality alone in the treatment of hypoxemic respiratory failure due to RSV pneumonia. The mechanism of increased lung expansion and alveolar recru itment appears to be responsible for a favorable clinical outcome. We concl ude that the combined therapy of HFV and iNO should be considered in hypoxe mic respiratory failure in pediatric patients.