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ONLINE Ph.D. DISSERTATION INFORMATION
The Ph.D. Dissertation Title: “Cost- Effectiveness of Nitric oxide inhalation in neonatal respiratory failure”.
Speciality: Pediatric – Neonatology

Code: 62.72.16. 01

Ph.D. candidate: Cam Ngọc Phượng
Supervisor1: Associate Professor, Ph.D. Vũ Minh Phúc,
Supervisor 2: Associate Professor, Ph.D. Phạm Thị Minh Hồng
Academic institute: University of Medicine and Pharmacy - Ho Chi Minh City
SUMMARY OF NEW FINDINGS:
This was a prospective study performed in neonatal intensive care unit in Children hospital 1, between
October, 2010 and April, 2013. By studying 50 newborns > 34 weeks gestation and < 30 days old with
respiratory failure requiring mechanical ventilation with an OI exceeded 25 or when the PaO2 while
receiving 100% O2 was less than 100mmHg, we could draw some conclusions:
1. The median mean age at study entry was 2,7 ± 0,9 days. Two third of cases had a difference with preductal saturations higher than post-ductal saturations.The mean oxygenation index at baseline was 69,6 ±
6,1. 81,5% of infants had bidirectional or right-to-left extrapulmonary shunt visualized by color Doppler
(at atrial and/or at the ductal level) at the time of study entry.
2. 60% demonstrated a sustained response to initiation of inhaled Ntric oxid, 22 % were defined as transient
responders and 18% were defined as nonresponders.
3. Infants with pulmonary hypertension secondary to sepsis and lung hypoplasia had a lower likelihood of
responding to iNO than infants with normal developmental lung. Infants with higher pH and lower OI had
a greater chance of responding to iNO. 82% improved after 30 to 60 minutts of therapy. Early responses to
iNO may not be sustained.
4. The peak MetHemoglobin level was 2,8%. The mean NO2 level was 0,5 ± 0,2 ppm. The prevalence of
chronic lung disease was 16%. The incidence of mild intracranial hemorrhage was 3%. Follow-up data on
30 infants showed that none of the infants had hearing loss, one had mild neurologic abnormality.
5. Overall mortality rate at 30 days old was 32%. Infants with pulmonary hypertension secondary to
pulmonary dysplasia or sepsis had a higher mortality rate than infants with persistent pulmonary
hypertension or hyaline membrane disease. The mean duration of Nitric oxid inhalation was 25,1 ± 11
hours and the median duration of assisted ventilation was 12days . The mean length of hospitalization

was 24 days.
6. With the survival rate at discharge of 68%, the mean cost effectiveness was 45.121.323 VND, in which
the mean cost for NO gas per case was 28.402.000 VND, accounted for 62,9% of total cost.
Ho Chi Minh city, February,11st, 2014
SUPERVISORS

Vũ Minh Phúc

Ph.D.candidate

Phạm Thị Minh Hồng
RECTOR

Cam Ngọc Phượng