Experience with mobile inhaled nitric oxide during transport of neonates and children with respiratory insufficiency to an extracorporeal membrane oxygenation center

Objective: To share our experience with the use of inhaled nitric oxide (iNO) during the transport of ventilated neonates and children to an extracorporeal membrane oxygenation (ECMO) center and to discuss the efficacy and safety of iNO use in this situation. Data Sources: Case note review of 55 consecutive patients transported while receiving iNO to Glenfield Hospital, Leicester, UK, for consideration of ECMO. Study Selection: Retrospective case note review. Data Extraction: The clinical condition of each patient recorded at arrival of the transport team at the referring hospital, during transport, and at arrival at Glenfield Hospital. Preclinical and postclinical conditions were compared using the paired Student's t-test. Data Synthesis: Overall data showed a significant improvement in transcutaneous oximetry measurements (SpO2: 84.8% preclinical, 90.6% postclinical; p= .006) and PaO2 (59 torr [7.87 kPa] preclinical, 84 torr [11.23 kPa] postclinical; p- .001) during transport in our patient group. Based on limited safety data, no untoward events or toxic metabolites were observed with iNO therapy during transport. Conclusions: iNO does appear to improve oxygenation during transfer of patients for ECMO in our series. Based on limited safety data, iNO appears safe to use in transport. (Pediatr Crit Care Med 2004; 5:542-546)