Strategy for the prevention of bacterial complications with inhaled nitrogen oxide in newborns

BACKGROUND: The nitrogen oxide molecule (NO) is a one of the most important factors in the anti-infectious resistance of the bodys immune system. AIM: This study aims to improve the effectiveness of preventing bacterial complications by including nitric oxide inhalations as part of traditional intensive care. MATERIALS AND METHODS: Ninety-seven full-term newborns without signs of bacterial complications were included in a controlled, randomized, blind clinical trial. The main group (n = 44) received inhaled nitrogen oxide (iNO). The control group (n = 53) did not receive iNO. On days 1, 5, and 20 the plasma concentrations of IL-1, IL-6, IL-8, TNF-, G-CSF, sFas, FGF, and NO were determined by capture ELISA; CD3+CD19, CD3CD19+, CD3+CD4+, CD3+CD8+, CD69+, CD71+, CD95+, CD3+HLA-DR+, CD14+, CD3CD56+, Annexin-V+/FITC; PI+/PE immunophenotype analysis. RESULTS: In the main group, sepsis developed in 4 patients and 13 controls (p1 = 0.04; p2 = 0.005). Fatalities occurred in 6 patients, and 10 controls (p1 = 0.37; p2 = 0.59) in the main group. The median duration of the IVL in the main group was 5 days, and 10 days for controls (p = 0.00007). Stays in ORIT were main 11 days for patients in the main group, and 15 days for controls (p = 0.026). On day 3, when compared with controls, patients in the main group had significantly reduced (p 0.05) of TNF-, IL-8 and IL-6, CD3+CD69+, CD3+CD95+, lymphocytes in apoptosis, increasing (p 0.05) G-CSF, sFas, FGF, NO; CD14+, CD3 +CD19. CONCLUSIONS: iNO used as a part of intensive care decreases the frequency of sepsis development, the duration of mechanical ventilation, and hospitalization. iNO also tends to decrease the lethal outcome frequency, reduces cytokine aggression, inhibits lymphocyte apoptosis, activates the monocyte-macrophage immunity and proliferative processes. It is appropriate to continue research.