Oxygenation Index – an Objective Indicator of the Severity and Treatment Effect of Persistent Pulmonary Hypertension of the Newborn

Abstract

The basis of PPHN pathogenesis is Right-to-Left shunt due to supra-systemic pulmonary pressure. Treatment of PPHN is complex and frequently ineffective. Medicaments influencing PPHN pathogenesis are pulmonary vasodilators. First-choice medicament is inhaled nitric oxide. The main thesis of the current study is: Overcoming pulmonary vasoconstriction by means of iNO will lead to the improvement of oxygenation and contribute to more immediate termination in newborns ventilatory support. The strategy is successful – infants from the iNO group quite logically require less ventilatory support compared to the control group, as evident by statistically significant differences in OI at the 24th and 48th hours. Oxygenation Index (OI) is an objective criterion that provides important information about the severity of PPHN and the effect of treatment applied. iNO decreases statistically significant OI at the 1st, 24th and 48th hour after initiation of the therapy. Treatment with iNO results in a more rapid hemodynamic stabilization of patients than conventional therapy of PPHN.