Imagine a newborn baby that is suffering from hypoxic respiratory failure, what would you do to help this? One of the major things that will help with this kind of issue in neonates is the administration of Nitric Oxide (NO). NO therapy has been approved by the FDA and is used in, not only neonates, but some adults. There are many advantages but there are also some disadvantages that will be discussed in this paper. NO therapies mode of action is classified as a pulmonary vasodilator. NO gas is full of lipid-soluble free radicals that combine with oxygen to become nitrogen dioxide (NO2). NO is normally produced in the body by a reaction catalyzed by the enzyme NO synthase. NO activates guanylate cyclase, which catalyzes the production of cyclic guanosine 3’, 5’-monophosphate (also called cGMP). The end result is that increased cGMP levels cause vascular smooth-muscle relaxation. This effect is helpful to patients’ respiratory tract by improving the blood flow to ventilated alveoli. The final result is a reduction in intrapulmonary shunting, improvement in arterial oxygenation, and a decrease in pulmonary vascular resistance and pulmonary arterial pressure (Committee, 2000). NO therapy has been effective in some adults, short-term, in treating acute respiratory distress (ARDS). This therapy has not been approved for adults because of this short term improvement and possible mortality.
The FDA approved the use of NO in 1999 to help hypoxic respiratory failure in premature babies greater than 34 weeks. Babies that are born with hypoxic respiratory failure have a hard time getting the oxygen to the tissues which makes them have the blue-ish tint to them when they are born. NO therapy helps transport the oxygen to the tissue which makes it a go to therapy when this situation occurs. Without this therapy doctors would have to resort to other options like surgery. While the FDA only has approved this therapy for neonates, NO therapy can also be