INHALED NITRIC-OXIDE THERAPY VIA NASOPHARYNGEAL TUBE IN AN INFANT WITH END-STAGE PULMONARY-HYPERTENSION

The delivery of nitric oxide (NO) via a nasopharyngeal tube is an alte rnative to endotracheal intubation. A male infant with end-stage pulmo nary hypertension (PH) due to a severe hypoplastic lung developed a PH crisis on day 145 and received NO inhalation via a nasopharyngeal tub e. Clinical improvement was maintained for 7 days with 18-22 ppm NO in halation. The patient remained in close physical contact with his pare nts without the use of sedation. Blood methemoglobin levels remained b elow 1%. The environmental NO levels were less than 0.06 ppm and NO2 l ess than 0.3 ppm throughout the treatment, well within the safety marg in. On day 152, the patient succumbed to hypoxemia and heart failure. The use of a nasopharyngeal NO delivery system without sedation, as an alternative to endotracheal intubation with sedation, was a practical method in treating a patient with PH while maintaining a certain qual ity of life for the patient and the family.