57 Role of Nitric Oxide on Oxidative Stress of Newborn. Experimental Study

Abstract

Background: Therapeutic inhalation of NO (iNO) in various pulmonary diseases is currently under evaluation in several neonatal intensive care units; it is difficult to establish an optimal dose regimen, but the aim should be to use as low an effective dose as possible, minimising the risks of potential toxicity.

Aims: Aim of this study was to determine effects iNO in newborn with pulmonary hypertension, with extreme hypoxia or with bronchopulmonary dysplasia, in particularly, which effects iNO has on inflammatory cascade, on oxidative stress and on clinical outcome.

Methods: Were investigated 70 newborns: 30 newborns of gestational age between 38and 40wks whit persistent pulmonary hypertension (group 1), 20 newborns of gestational age < 30 wks of birthweight < 1500 gr, with severe respiratory distress and with extreme hypoxia (group 2), 20 newborns of birthweight < 1200 gr, requirement for supplementary oxygen >40 % at between 10 and 30 days, with radiological findings of Chronic Lung Disease (group 3). Nitric oxide was given at dosage of 20 ppm in newborn. with Pulmonary Persistent Hypertension or with extreme hypoxia, at dosage of 2–3 ppm in babies with CLD..

Results: Newborns of all the three groups presented an amelioration of oxygenation rate and alveolar/capillary rate that permitted to reduce ventilatory parameters (FiO2, PIP). At time 0 IL-6 blood concentrations were significantly higher in newborn of group 2and of group 3than in subjects of group 1. At 72 hours and at 7 days we have a progressive increase of concentration of this interleukin in the group 1 and 2 and a progressive reduction in the newborn of group 3. Also IL-8 concentrations at time 0 were significantly higher in newborn of group 2 and of group 3 than in subjects of group 1. Also IL 8 concentrations were significantly increased from 24 hours to 7 days (p <0.01) in groups 1 and 2 1 and in the 2 group and significantly decreased in the newborn of 3 group. TNFa concentrations at time 0 were significantly higher in newborn of group 2 and of group 3 than in subjects of group 1. Also TNFa concentrations were significantly increased from 24 hours to 7 days (p <0.01) in groups 1 and 2 1 and in the 2 group and significantly decreased in the newborn of 3 group.

Conclusion: In our study we have demonstrated as iNO can ameliorate oxygenation index, alveolar/capillary rate with a reduction of ventilator paramethers in all three groups. Our study shows also as iNO can have a pro and antioxidant role on the basis of administered doses: where iNO was administered at dosage of 20ppm have been obtained a progressive rising of blood levels of interleukins; where iNO's dosage was 2–3 ppm have been obtained a progressive reduction of proinflammatory cytokines.

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