Lung disease and brain damage can be reduced for the smallest premature babies if they are treated with nitric oxide, according to two studies – including one by doctors at The Children’s Hospital and the University of Colorado.
The studies, which appear in this week’s New England Journal of Medicine, offer a possible treatment to prevent some of the most common, and serious, complications of preterm birth.
In 2004, 12.5 percent of infants – about 500,000 – were born preterm, according to the federal Centers for Disease Control and Prevention.
Nitric oxide in the human body helps regulate cell functions. It’s the same chemical that controls a firefly’s light.
Dr. Elizabeth Nabel, director of the National Heart, Lung and Blood Institute, said the findings could help doctors identify which babies might benefit from the treatment.
More research is necessary to determine the long-term effects of the treatment, said Dr. John Kinsella, a neonatologist at The Children’s Hospital.
Still, Kinsella said, “these are very promising findings.”
In Kinsella’s study, 800 preterm babies either inhaled nitric oxide within 48 hours of birth or were given a placebo.
The results were broken down by babies’ birth weights.
Infants who weighed about 2 pounds at birth and got the treatment had half the risk of brain damage of those who did not get treated.
In addition, babies born weighing 2.5 pounds were half as likely to develop chronic lung problems if they received the treatment.
In a similar study of 600 babies, led by doctors at the Children’s Hospital of Philadelphia, preterm babies who received the nitric oxide had less lung disease – and less-severe disease – than those who were given a placebo.
In both studies, there was a small increase in survival among the babies getting the treatment.
Pam Johnson is convinced her son Sean wouldn’t have made it without nitric oxide.
When Sean was born, at 32 weeks, he weighed a little over 4 pounds, but because of complications during the pregnancy, his lungs were severely underdeveloped.
“They said they could not push enough oxygen through his lungs for him to live,” Johnson said.
Sean was not part of the study, but under Kinsella’s guidance, Sean’s doctors at the University of Colorado Hospital gave him nitric oxide.
When Sean finally got to go home to Estes Park two months later, he was still on oxygen. But, Johnson said, her son is fine.
Sean starts kindergarten next month and “is right on target with everything,” Johnson said.
Nitric oxide was approved in 1999 for use in full-term babies with severe respiratory failure.
Preterm babies – those born before 37 weeks’ gestation – have high risks of a number of developmental disabilities and respiratory ailments.
The chronic lung disease often caused by premature birth produces an estimated $2.4 billion a year in health care costs, a CDC report found.
In the body, nitric oxide acts as a signaling molecule and regulates a diverse range of responses, including transmitting signals from the brain and the regulation of cell death.
In 1998, the Nobel Prize went to three Americans who discovered that nitric oxide – which is different from nitrous oxide, also known as laughing gas – was a signal molecule.
Tuesday, Kinsella thanked parents who agreed to let their babies be part of the research.
“It will really help generations to come,” he said.
Pam Johnson is grateful Sean got the treatment.
“We’re so happy he’s here, we don’t know what to do,” she said. “They did a good thing.”
Staff writer Karen Augé can be reached at 303-820-1733 or kauge@denverpost.com.
