What is the role of inhaled nitric oxide in the management of PPHN?

• A. It reduces pulmonary vascular resistance and improves oxygenation
• B. It should be used in all neonates with respiratory distress
• C. It cures PPHN permanently
• D. It is contraindicated in term infants

Answer: (A)

Inhaled nitric oxide acts as a selective pulmonary vasodilator, rapidly lowering the resistance in the pulmonary arteries. By relaxing smooth muscle in the lungs, it improves blood flow to well-ventilated areas, increases oxygenation, and reduces the right-to-left shunting that drives hypoxemia in Persistent Pulmonary Hypertension of the Newborn.

This therapy is fast-acting and helps rebalance ventilation and perfusion, but it is not a cure for PPHN and may not work in all cases or in other causes of respiratory distress. It’s not contraindicated for term infants; it’s used specifically when PPHN or pulmonary hypertension is present, with careful monitoring for potential side effects such as methemoglobinemia.