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Inhaled Nitric Oxide in Neonates With Elevated A-a DO2 Gradients Not Requiring Mechanical Ventilation

This study has been terminated.
(slow enrollment)
Information provided by (Responsible Party):
Mallinckrodt Identifier:
First received: July 10, 2002
Last updated: October 18, 2016
Last verified: October 2016
The purpose of this pilot study is to evaluate whether administration of nitric oxide (NO)gas by oxygen hood at 20 ppm significantly increases PaO2, as compared to placebo gas (oxygen), within one hour of initiation and with no significant adverse effects.

Condition Intervention Phase
Lung Disease Hypoxemia Respiratory Acidosis Drug: nitric oxide for inhalation Drug: Oxygen Phase 1 Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: Inhaled Nitric Oxide in Neonates With Elevated A-a DO2 Gradients Not Requiring Mechanical Ventilation

Resource links provided by NLM:

Further study details as provided by Mallinckrodt:

Primary Outcome Measures:
  • PaO2 level [ Time Frame: at baseline, then every hour for 6 hours ]

Secondary Outcome Measures:
  • Methemoglobin level [ Time Frame: at baseline then every hour of treatment ]
  • Alveolar-arterial oxygen gradient and ratio [ Time Frame: after 1 hour of treatment ]

Enrollment: 7
Study Start Date: May 2002
Study Completion Date: June 2005
Primary Completion Date: June 2005 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
Nitric Oxide for Inhalation
Drug: nitric oxide for inhalation
given at 20 ppm for 1 hour then weaned off over 4 hours
Other Name: INOmax
Placebo Comparator: 2
Drug: Oxygen
given at 20 ppm for one hour, then weaned off over four hours

Detailed Description:

It is possible that administration of inhaled NO to neonates with abnormal gas exchange earlier, rather than later as a rescue therapy in a moribund state, might accelerate the transition of the circulation from the fetal to neonatal physiology and improve oxygenation. This may in turn decrease the need for mechanical ventilation, its associated morbidity and perhaps even ECMO.

This study is designed as a pilot study to evaluate the physiologic efficacy (rather than effect on clinical outcomes) of NO administered by hood in improving oxygenation of neonates with elevated A-a DO2.


Ages Eligible for Study:   up to 120 Hours   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion criteria:

  • Gestational age >34 completed weeks (>=35)
  • Age <48 hours
  • A-a DO2 400 to 600, on two post-ductal arterial blood gases one hour apart, while on 100% O2 by oxygen hood
  • Post-ductal arterial access
  • Admitted to The University of Alabama Birmingham Regional NICU

Exclusion criteria:

  • Cardiac disease (structural disease with right to left or mixing lesions), not including patent ductus arteriosus (PDA) or patent foramen ovale (PFO)
  • Rapid deterioration requiring mechanical ventilation before entry into the study
  • Major malformations
  • Major neurologic or metabolic disorder or other illness leading to hypoventilation and hypercarbia
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Please refer to this study by its identifier: NCT00041548

United States, Alabama
The University of Alabama Birmingham
Birmingham, Alabama, United States, 35233
Sponsors and Collaborators
Principal Investigator: Waldemar Carlo, MD University of Alabama at Birmingham
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Mallinckrodt Identifier: NCT00041548     History of Changes
Other Study ID Numbers: CARLW1
Study First Received: July 10, 2002
Last Updated: October 18, 2016

Additional relevant MeSH terms:
Lung Diseases
Acidosis, Respiratory
Respiratory Tract Diseases
Signs and Symptoms, Respiratory
Signs and Symptoms
Acid-Base Imbalance
Metabolic Diseases
Respiratory Insufficiency
Respiration Disorders
Nitric Oxide
Bronchodilator Agents
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Asthmatic Agents
Respiratory System Agents
Free Radical Scavengers
Molecular Mechanisms of Pharmacological Action
Neurotransmitter Agents
Endothelium-Dependent Relaxing Factors
Vasodilator Agents
Protective Agents processed this record on June 23, 2017