Abstract
Two cases of successful reversal from PFC (persistent fetal circulation) by inhaled NO are reported. CASE 1 : A male neonate, 2580 gm/37 weeks, with perforated ileal atresia was transferred in a shock condition. After resuscitation, resection of the necrotic segment and ileo-ileostomy were done. Postoperative course was complicated with necrotizing fasciitis of abdominal wall, sepsis, and PFC. Intracranial hemorrhage and ongoing hemolysis precluded ECMO. Inhaled NO therapy (20ppm) dramatically reversed PFC and was discotinued at 48 hrs of therapy. CASE 2 : A male neonate, 2330 gm/36 wks, was transferred due to congenital diaphragmatic hernia (pH 7.19, AaDO_2 631mmHg). He was stabilized with HFO and underwent repair, using Cortex sheet and skin flap closure of the abdomen. PFC developed but was reversed by NO therapy (6ppm). Retrospectively, this case was associated with severe lung hypoplasia. The inhaled Nitric Oxide (NO) therapy is an effective therapeutic modality for PFC in neonates and is more easily accessible than ECMO.
