University of Oulu

Greenough, A., Decobert, F., Field, D., Hallman, M., Hummler, H. D., Jonsson, B., Sánchez Luna, M., Van Overmeire, B., Carnielli, V. P., Potenziano, J. L., & Mercier, J. (2021). Inhaled nitric oxide (iNO) for preventing prematurity-related bronchopulmonary dysplasia (BPD): 7-year follow-up of the European Union Nitric Oxide (EUNO) trial, Journal of Perinatal Medicine, 49(1), 104-110. doi:

Inhaled nitric oxide (iNO) for preventing prematurity-related bronchopulmonary dysplasia (BPD) : 7-year follow-up of the European Union Nitric Oxide (EUNO) trial

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Author: Greenough, Anne1; Decobert, Fabrice2; Field, David3;
Organizations: 1King’s College London, London, UK
2Centre Hospitalier Intercommunal de Créteil,Créteil, France
3University of Leicester Centre for Medicine, Leicester, UK
4University of Oulu and Oulu University Hospital, Oulu,Finland
5Sidra Medicine, Doha, Qatar; University of Ulm,Ulm, Germany
6Karolinska University Hospital and Institute,Stockholm, Sweden
7Hospital General Universitario “GregorioMarañón,” Madrid, Spain
8Université Libre de Bruxelles, Brussels, Belgium
9Polytechnical University of Marche, Ancona, Italy
10Mallinckrodt Pharmaceuticals, Bedminster, NJ, USA
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link:
Language: English
Published: De Gruyter, 2021
Publish Date: 2021-01-21


Objectives: Most studies of inhaled nitric oxide (iNO) for prevention of bronchopulmonary dysplasia (BPD) in premature infants have focused on short-term mortality and morbidity. Our aim was to determine the long-term effects of iNO.

Methods: A 7-year follow-up was undertaken of infants entered into a multicenter, double-blind, randomized, placebo-controlled trial of iNO for prevention of BPD in premature infants born between 24 and 28 weeks plus six days of gestation. At 7 years, survival and hospital admissions since the 2-year follow-up, home oxygen therapy in the past year, therapies used in the previous month and growth assessments were determined. Questionnaires were used to compare general health, well-being, and quality of life.

Results: A total of 305 children were assessed. No deaths were reported. Rates of hospitalization for respiratory problems (6.6 vs. 10.5%, iNO and placebo group, respectively) and use of respiratory medications (6.6 vs. 9.2%) were similar. Two patients who received iNO and one who received placebo had received home oxygen therapy. There were no significant differences in any questionnaire-documented health outcomes.

Conclusions: iNO for prevention of BPD in very premature infants with respiratory distress did not result in long-term benefits or adverse long-term sequelae. In the light of current evidence, routine use of iNO cannot be recommended for prevention of BPD in preterm infants.

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Series: Journal of perinatal medicine
ISSN: 0300-5577
ISSN-E: 1619-3997
ISSN-L: 0300-5577
Volume: 49
Issue: 1
Pages: 104 - 110
DOI: 10.1515/jpm-2020-0164
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: This study was sponsored by Mallinckrodt Pharmaceuticals. Medical writing and editorial support was provided by Michael D. Morren, RPh, MBA, of Peloton Advantage, Dana Torchia, MBA, LLC, an OPEN Health company, sponsored by Mallinckrodt Pharmaceuticals.
Copyright information: © 2021 Anne Greenough et al., published by De Gruyter. This work is licensed under the Creative Commons Attribution 4.0International License.