Just Say No to Inhaled Nitric Oxide in the Neonatal Intensive Care Unit

Studies are inconclusive regarding the protective effect of inhaled nitric oxide (NO) on bronchopulmonary dysplasia (BPD) in extremely preterm infants. In an industry-funded, placebo-controlled, double-blind trial, investigators at 36 centers in Europe randomized 800 extremely preterm infants (gestational age, 24 weeks to 28 weeks and 6 days) who required surfactant or continuous positive airway pressure to receive inhaled low-dose NO (5 parts per million) or placebo (nitrogen gas) for 1 to 3 weeks. Infants included required at least 0.3 fractional oxygen concentration on mean airway pressure of at least 4 cm of water to maintain oxygen saturation of 85%. Infants who required more than 0.5 fractional oxygen concentration on mean airway pres…