Am J Perinatol 2003; 20(3): 137-146
DOI: 10.1055/s-2003-40012
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Expired Nitric Oxide in the Newborn with High Risk of Perinatal Infection

J. Figueras-Aloy1 , Y. Jordín1 , J. M. Rodraguez-Miguélez1 , W. Jiménez2 , F. Botet1 , X. Carbonell1 , R. Jiménez1
  • 1Neonatal Unit, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Hospital Clínic, Universitat de Barcelona, Spain
  • 2Hormonal Laboratory, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Unitat Integrada de Pediatria, Hospital Clínic, Universitat de Barcelona, Spain
Further Information

Publication History

Publication Date:
12 June 2003 (online)

ABSTRACT

The objective of this study is to determine expired nitric oxide (expNO) in the first 3 days of life in relation to: hours of life, gestational age, type of labor, and risk of perinatal infection. Our hypothesis has been that expNO increases in newborns with high risk of perinatal infection. Total expNO was measured in 166 newborns: 108 healthy (63 full-term and 45 preterm), 30 with low risk of perinatal infection, and 28 with high risk of perinatal infection treated with antibiotics but without positive hemoculture. Expired gas was collected using a face mask and NO concentration was determined by chemiluminescence. Total expNO neither correlated with gestational age, birth weight or serum NOx, nor changed after cesarean section, but was related to hours of life. Total expNO in the ≤ 36-hour subgroups (median, interquartile range) was higher in the high-risk perinatal infection newborns (n = 8; 5.33 (4.5-7.2) nL/min1Kg) than in healthy newborns (n = 59; 4.13 (3.5-4.7) nL/min1kg) or low-risk perinatal infection newborns (n = 18; 3.99 (3.4-4.7) nL/min1 kg). In the 37 to 72-hour subgroups there were also differences between healthy newborns (n = 49; 4.68 (4.1-5.3) nL/min1 kg) or low-risk perinatal infection newborns on the one hand (n = 12, 4.55 (3.9-5.2) nL/min1 kg) and high risk perinatal infection newborns on the other (n = 20; 9.69 (7.6-11.1) nL/min1 kg). Then, total expNO increased in newborns with high risk of perinatal infection, regardless of hours of life.

REFERENCES

  • 1 Roger N, Barberá J A. Oxido nítrico: una molécula importante en las enfermedades respiratorias.  Arch Bronconeumol . 1994;  9 454-461
  • 2 Lundberg J ON, Rinder J, Weitzberg E, Lundberg J M, Alving K. Nasally expired nitric oxide in humans originates mainly in the paranasal sinuses.  Acta Physiol Scand . 1994;  152 431-432
  • 3 Gerlach H, Rossaint R, Pappert D, Knorr M, Falke K J. Autoinhalation of nitric oxide after endogenous synthesis in nasopharynx.  Lancet . 1994;  343 518-519
  • 4 Schedin U, Frostell C, Persson M G, Jakobson J, Anderson G, Gustaffson L E. Contribution from upper and lower airways to expired endogenous nitric oxide in humans.  Acta Anaesthesiol Scand . 1995;  39 327-332
  • 5 Persson M G, Wiklund N P, Gustafsson L E. Endogenous nitric oxide in single exhalations and the change during exercise.  Am Rev Respir Dis . 1993;  148 1210-1214
  • 6 Persson M G, Zetterstrom O, Agrenius V, Ihre E, Gustafsson L S. Single-breath nitric oxide measurements in asthmatic patients and smokers.  Lancet . 1994;  343 146-147
  • 7 Kharitonov S A, Wells A U, O'Connor B J. et al . Elevated levels of expired nitric oxide in bronchiectasis.  Am J Respir Crit Care Med . 1995;  151 1889-1993
  • 8 Kharitonov S A, Yates D, Barnes P J. Increased nitric oxide in expired air of normal subjects with upper respiratory tract infections.  Eur Respir J . 1995;  8 295-297
  • 9 Matsumoto A, Ogura K, Hirata Y. et al . Increased nitric oxide in the expired air of patients with decompensated liver cirrhosis.  Ann Inter Med . 1995;  123 110-113
  • 10 Persson M G, Agvald P, Gustafsson L E. Detection of nitric oxide in expired air during administration of nitroglycerine in vivo.  Br J Pharmacol . 1994;  111 825-828
  • 11 Schilling J, Holzer P, Guggenbach M, Gyurech D, Marathia K, Geroulanos S. Reduced endogenous nitric oxide in the expired air of smokers and hypertensives.  Eur Respir J . 1994;  7 467-471
  • 12 Persson M G, Cederqvist B, Wiklund C U, Gustafsson L E. Ethanol causes decrements in airway excretion of endogenous nitric oxide in humans.  Eur J Pharmacol . 1994;  270 273-278
  • 13 Hall G L, Reinmann B, Wildhaber J H, Frey U. Tidal exhaled nitric oxide in healthy, unsedated newborn infants with prenatal tobacco exposure.  J Appl Physiol . 2002;  92 59-66
  • 14 Elphick H E, Demoncheaux E A, Ritson S, Higenbottam T W, Everard M L. Exhaled nitric oxide is reduced in infants with cystic fibrosis.  Thorax . 2001;  56 151-152
  • 15 Morris N H, Carroll S, Nicolaides K H, Steer P J, Warren J B. Expired nitric oxide concentration and amniotic fluid nitrite concentration during pregnancy.  Eur J Clin Invest . 1995;  25 138-141
  • 16 Schedin U, Norman M, Gustafsson L E, Herin P, Frostell C. Endogenous nitric oxide in the upper airways of healthy newborn infants.  Pediatr Res . 1996;  40 148-151
  • 17 Schedin U, Norman M, Gustafsson L E, Jonsson B, Frostell C. Endogenous nitric oxide in the upper airways of premature and term infants.  Acta Paediatr . 1997;  86 1229-1235
  • 18 Arlich A, Busch T, Lewandowski K, Schaible T, Falke K J, Gortner L. Expired nitric oxide in preterm infants.  Respir Physiol . 1998;  114 195-200
  • 19 Figueras J, Rodríguez-Miguélez J M, Jordan Y, Botet F, Moreno J, Jiménez R. A different methodology for evaluating expired endogenous nitric oxide in newborns.  Acta Paediatr . 1999;  88 471-472
  • 20 Misko P T, Schilling R J, Salvemini D M, Moore W M, Cunie M G. A fluorometric assay for the measurement of nitrite in biological samples.  Ann Biochem . 1993;  214 11-16
  • 21 Figueras J, Rodríguez-Miguélez J M, Moliner E, Botet F, Moreno J, Jiménez R. Expired nitric oxide in newborns: prenatal and neonatal medicine. Abstracts of the XVth European Congress of Perinatal Medicine Glasgow: Parthenon Publishing 1996: 234
  • 22 Lundberg J O, Weitzberg E, Lundberg J M, Alving K. Intragastric nitric oxide production in humans: measurements in expelled air.  Gut . 1994;  35 1543-1546
  • 23 Figueras J, Jordan Y, Rodríguez-Miguélez J M, Jiménez R. Óxido nítrico exhalado en el recién nacido.  An Esp Pediatr . 1999;  S129 121-126
  • 24 Artlich A, Jónsson B, Bhiladvala M, Lönnqvist P A, Gustafsson L E. Single breath analysis of endogenous nitric oxide in the newborn.  Biol Neonate . 2001;  79 21-26
  • 25 Valls A, Gastiasoro E, López de Heredia J. Estudio de la mecánica pulmonar en recién nacidos a término sin problemas respiratorios.  An Esp Pediatr . 1990;  33 511-514
  • 26 Gastiasoro E, López de Heredia J, Valls A. Estudio de la mecánica pulmonar en recién nacidos pretérmino sin problemas respiratorios.  An Esp Pediatr . 1992;  36 363-366
  • 27 Endo A, Ayusawa M, Minato M, Takada M, Takahashi S, Harada K. Endothelium-derived relaxing and contracting factors during the early neonatal period.  Acta Paediatr . 1997;  86 834-836
  • 28 Biban P, Zangardi T, Baraldi E, Dussini N, Chiandetti L, Zacchello F. Mixed exhaled nitric oxide and plasma nitrites and nitrates in newborn infants.  Life Sci . 2001;  68 2789-2797
  • 29 Shi Y, Li H Q, Schen C K, Wang J H, Qin S W, Liu R, Pan J. Plasma nitric oxide levels in newborn infant with sepsis.  J Pediatr . 1993;  123 435-438
  • 30 Lundberg J O, Weitzberg E, Nordvall S L, Kuylenstierna R, Lundberg J M, Alving K. Primarily nasal origin of expired nitric oxide and absence in Kartagener's syndrome.  Eur Respir J . 1994;  7 1501-1504
    >