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: 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 60% demonstrated a sustained response to initiation of inhaled Ntric oxid, 22 % were defined as transient responders and 18% were defined as nonresponders 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 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 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 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