Which statement about nitric oxide use in premature neonates is accurate according to trials?

• A. It improved survival
• B. It did not improve survival nor prevent bronchopulmonary dysplasia
• C. It significantly reduced NEC
• D. It is contraindicated in all neonates

Answer: (B)

Inhaled nitric oxide has not shown a survival or bronchopulmonary dysplasia (BPD) benefit in premature neonates based on randomized trials. While nitric oxide can help with pulmonary vasodilation and is effective for PPHN in term infants, the lungs of very preterm babies respond differently, and the expected improvements in survival or reduction of BPD have not been demonstrated in this population. Across large trials and meta-analyses, iNO did not reduce mortality or prevent BPD in preterm infants, and concerns about potential adverse effects have tempered enthusiasm for routine use in this group. So the accurate takeaway from the trials is that inhaled nitric oxide did not improve survival nor prevent BPD in premature neonates.