{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:18:08Z","timestamp":1774916288269,"version":"3.50.1"},"reference-count":32,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"published-print":{"date-parts":[[1997,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>AIM<\/jats:title>\n                  <jats:p>To determine if infants who had become dependent on inhaled nitric oxide treatment could be successfully weaned off it if FIO<jats:sub>2<\/jats:sub> was increased briefly during withdrawal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec sec-type=\"methods\">\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Sixteen infants admitted for conditions associated with increased pulmonary vascular resistance responded well to inhaled nitric oxide treatment with a significant increase in PaO<jats:sub>2<\/jats:sub> (maximum inhaled nitric oxide given 25 ppm). Weaning from inhaled nitric oxide in 5 ppm decrements was initiated once the FIO<jats:sub>2<\/jats:sub> requirement was less than 0.5. When patients were stable on 5 ppm of inhaled nitric oxide, the gas was then discontinued. If a patient showed inhaled nitric oxide dependence\u2014that is, oxygen saturation fell by more than 10% or below 85%\u2014inhaled nitric oxide was reinstated at 5 ppm and the patient allowed to stabilise for 30 minutes. At this time, FIO<jats:sub>2<\/jats:sub> was increased by 0.40 and weaning from inhaled nitric oxide was attempted again.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Nine infants were successfully weaned on the first attempt. The seven infants who failed the initial trial were all successfully weaned following the increase in FIO<jats:sub>2<\/jats:sub>. After successful weaning, FIO<jats:sub>2<\/jats:sub> was returned to the pre-weaning level in mean 148(SD 51) minutes and inhaled nitric oxide was never reinstated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSION<\/jats:title>\n                  <jats:p>Infants showing inhaled nitric oxide dependency can be successfully weaned by increasing FIO<jats:sub>2<\/jats:sub> transiently.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/fn.76.2.f118","type":"journal-article","created":{"date-parts":[[2009,4,8]],"date-time":"2009-04-08T11:48:05Z","timestamp":1239191285000},"page":"F118-F122","source":"Crossref","is-referenced-by-count":26,"title":["Weaning strategy with inhaled nitric oxide treatment in persistent pulmonary hypertension of the newborn"],"prefix":"10.1136","volume":"76","author":[{"given":"Hany","family":"Aly","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rakesh","family":"Sahni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jen-Tien","family":"Wung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1997,3,1]]},"reference":[{"key":"2025090513181252000_76.2.F118.1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1203\/00006450-199002000-00005","article-title":"Endothelium-derived relaxing factor: Presence in pulmonary and systemic arteries of the newborn guinea pig.","volume":"27","author":"Davidson","year":"1990","journal-title":"Pediatr Res"},{"key":"2025090513181252000_76.2.F118.2","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1203\/00006450-199106010-00004","article-title":"Endothelium-derived relaxing factor: evidence that it regulates pulmonary vascular resistance in the isolated newborn guinea pig lung.","volume":"29","author":"Davidson","year":"1991","journal-title":"Pediatr Res"},{"key":"2025090513181252000_76.2.F118.3","first-page":"H1921","article-title":"Role of endothelium-derived relaxing factor during transition of pulmonary circulation at birth.","volume":"259","author":"Abman","year":"1990","journal-title":"Am J Physiol"},{"key":"2025090513181252000_76.2.F118.4","first-page":"H355","article-title":"Oxygen Modulates endothelium-derived relaxing factor production in fetal pulmonary arteries.","volume":"262","author":"Shaul","year":"1992","journal-title":"Am J Physiol"},{"key":"2025090513181252000_76.2.F118.5","first-page":"H406","article-title":"Acetyl choline increases pulmonary blood flow in intact fetuses via endothelium-dependent vasodilatation.","volume":"262","author":"Tiktinsky","year":"1992","journal-title":"Am J Physiol"},{"key":"2025090513181252000_76.2.F118.6","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)92687-B"},{"key":"2025090513181252000_76.2.F118.7","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1161\/01.RES.72.2.246","article-title":"Inhaled nitric oxide reverses pulmonary vasoconstriction in the hypoxic and acidotic newborn lamb.","volume":"72","author":"Roberts","year":"1993","journal-title":"Circ Res"},{"key":"2025090513181252000_76.2.F118.8","doi-asserted-by":"publisher","DOI":"10.1063\/1.354934"},{"key":"2025090513181252000_76.2.F118.9","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)92686-A"},{"key":"2025090513181252000_76.2.F118.10","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1080\/00039896.1972.10666066","article-title":"Early response of lungs to low levels of nitrogen dioxide.","volume":"24","author":"Stephens","year":"1972","journal-title":"Arch Environ Health"},{"key":"2025090513181252000_76.2.F118.11","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1007\/BF00377770","article-title":"Effect of exposure to 43 ppm nitric oxide and 3.6 nitrogen dioxide on rabbit lung.","volume":"42","author":"Hugod","year":"1979","journal-title":"Int Arch Occup Environ Health"},{"key":"2025090513181252000_76.2.F118.12","unstructured":"Hugod C (1977) Ultrastructural changes of the rabbit lung after 5 ppm nitric oxide exposure. 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A selective pulmonary vasodilator reversing hypoxic pulmonary vasoconstriction.","volume":"83","author":"Frostell","year":"1991","journal-title":"Circulation."},{"key":"2025090513181252000_76.2.F118.20","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/S0140-6736(94)92791-X","article-title":"Down-regulation of endogenous nitric oxide production after prolonged administration.","volume":"344","author":"Petros","year":"1994","journal-title":"Lancet"},{"key":"2025090513181252000_76.2.F118.21","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S0140-6736(95)92681-X","article-title":"Rebound pulmonary hypertension on withdrawal from inhaled nitric oxide.","volume":"346","author":"Miller","year":"1995","journal-title":"Lancet"},{"key":"2025090513181252000_76.2.F118.22","unstructured":"Short BL (1993) Clinical management of the neonatal ECMO patient. in Extra -corporeal Life Support. eds Arensman R Cornish D (Blackwell Scientific, Oxford), pp 195\u2013206."},{"key":"2025090513181252000_76.2.F118.23","doi-asserted-by":"publisher","DOI":"10.1038\/333664a0"},{"key":"2025090513181252000_76.2.F118.24","doi-asserted-by":"publisher","DOI":"10.1016\/0006-291X(91)91268-H"},{"key":"2025090513181252000_76.2.F118.25","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1097\/00000542-199112000-00011","article-title":"Inhaled nitric oxide: A selective pulmonary vasodilator of heparin-protamine vasoconstriction in the sheep.","volume":"75","author":"Fratacci","year":"1991","journal-title":"Anesthesiol"},{"key":"2025090513181252000_76.2.F118.26","first-page":"H2221","article-title":"Direct and reversible inhibition of endothelial nitric oxide synthase by nitric oxide.","volume":"268","author":"Ravichandran","year":"1995","journal-title":"Am J Physiol"},{"key":"2025090513181252000_76.2.F118.27","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1203\/00006450-199501000-00007","article-title":"Urinary nitrite and nitrate concentrations in patients with idiopathic persistent pulmonary hypertension of the newborn and effect of extracorporeal membrane oxygenation.","volume":"37","author":"Dollberg","year":"1995","journal-title":"Pediatr Res"},{"key":"2025090513181252000_76.2.F118.28","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.52.3.352"},{"key":"2025090513181252000_76.2.F118.29","doi-asserted-by":"publisher","DOI":"10.1016\/0014-2999(85)90496-0"},{"key":"2025090513181252000_76.2.F118.30","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/S0026-895X(25)13761-9","article-title":"Evidence that CGMP is the mediator of endothelium-dependent inhibition of contractile responses of rat arteries to adrenoceptor stimulation.","volume":"32","author":"MacLeod","year":"1987","journal-title":"Mol Pharmacol"},{"key":"2025090513181252000_76.2.F118.31","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1152\/jappl.1995.78.4.1288","article-title":"Prolonged pulmonary vasodilator action of inhaled nitric oxide by zaprinast in awake lambs.","volume":"78","author":"Ichinose","year":"1995","journal-title":"J Appl Physiol"},{"key":"2025090513181252000_76.2.F118.32","first-page":"H1299","article-title":"N-omega-nitro-L-arginine attenuates endothelium dependent pulmonary vasodilatation in lambs.","volume":"260","author":"Fineman","year":"1991","journal-title":"Am J Physiol"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/fn.76.2.F118","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T20:18:23Z","timestamp":1757103503000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/fn.76.2.F118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,3,1]]},"references-count":32,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1997,3,1]]},"published-print":{"date-parts":[[1997,3,1]]}},"alternative-id":["10.1136\/fn.76.2.F118"],"URL":"https:\/\/doi.org\/10.1136\/fn.76.2.f118","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"value":"1359-2998","type":"print"},{"value":"1468-2052","type":"electronic"}],"subject":[],"published":{"date-parts":[[1997,3,1]]}}}