|
|
|
Course Title |
|
Hypoxic Respiratory Failure in the Newborn: The Role of Inhaled Nitric Oxide
|
|
|
Faculty |
|
Donald M. Null, MD
Neonatologist, Newborn Intensive Care Unit
Primary Children’s Medical Center
University of Utah Medical Center and Intermountain Medical Center Salt Lake City, UT |
|
|
Credit Hours |
|
0.5 AMA PRA Category 1 Credit(s)™
|
0.5 Contact hour ANCC
|
|
Program Overview |
|
Hypoxic respiratory failure (HRF) in neonates is a common clinical problem in pediatrics, and can arise as a primary developmental disorder or as a complication of another condition, such as meconium aspiration syndrome, sepsis, pneumonia, or pulmonary hypoplasia. Although there is limited recent information on the epidemiology of neonatal HRF, data from 2001 suggest that 2% of all babies born alive in the US each year will require mechanical ventilation for neonatal respiratory failure. This represents more than 79,000 neonates, based on 2012 birth rates. Given how common HRF is in the neonatal period, it is important for physicians and nurses to be able to rapidly and accurately identify the early signs of respiratory distress and to initiate appropriate treatment. Treatment will include interventions to optimize lung volumes, reduce pulmonary vascular resistance, and improve cardiac function, and may include the use of mechanical ventilation, oxygen, drug therapy, and inhaled nitric oxide (NO), which is approved for the use of term or near-term neonates with HRF and evidence of pulmonary hypertension.
|
|
|
Commercial Support |
|
This enduring internet activity is supported through an independent educational grant from Ikaria
|
|
|
Learning Objectives |
|
At the completion of this activity, participants will be better able to:
• Define hypoxic respiratory failure (HRF) and describe the risk factors, clinical signs, common comorbidities, and
differential diagnoses associated with HRF in neonates.
• Understand the cardiopulmonary pathophysiology underlying the development of neonatal HRF, in particular the interactions between lung disease, cardiac dysfunction, and pulmonary hypertension
• Appreciate the rationale for treatment approaches that selectively dilate pulmonary vessels
• Understand the clinical trial data that support the use of inhaled nitric oxide (iNO) in neonates with HRF.
• Describe the important safety precautions that need to be taken with the use of iNO, including the rationale for
avoiding abrupt discontinuation, monitoring of PaO2, methemoglobin, and inspired NO2 during therapy, and
recognition that use in patients with preexisting left ventricular dysfunction may experience serious side effects.
• Establish appropriate treatment protocols for the management of neonatal HRF within their own clinical environments.
|
|
|
Format/Medium |
|
Flash Player
|
|
|
Accreditation Statement |
|
Physicians
The Meniscus Educational Institute is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The Meniscus Educational Institute designates this enduring material (273.002-1403-MI) for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurses
This enduring activity (273.002-1403-NI) for 0.5 contact hours is provided by the Meniscus Educational Institute. The
Meniscus Educational Institute is accredited as a provider of continuing nursing education by the American Nurses Credentialing
Center’s Commission on Accreditation.
Accreditation refers to recognition of educational activities only and does not imply approval or endorsement by the Meniscus
Educational Institute or the American Nurses Credentialing Center’s Commission on Accreditation of any product mentioned.
Provider approved by the California Board of Registered Nursing, Provider No. 13164, for 0.5 contact hours.
|
|
|
Disclosure Policy |
|
All individuals in positions to control the content of this program (eg, planners, faculty, content reviewers) are expected to disclose all financial relationships with commercial interests that may have a direct bearing on the subject matter of this continuing education activity. Participants have the responsibility to assess the impact (if any) of the disclosed information on the educational value of the activity.
|
|
|
Faculty Disclosure |
|
Donald M. Null, MD has served as a consultant for Drager and has received honoraria from Ikaria.
|
|
|
Planning Committee Disclosure |
|
Robert Bieber has nothing to disclose.
Terry Logan, CCMEP has nothing to disclose .
Alexandra Novitsky, MD, has nothing to disclose.
Christine Reynolds has nothing to disclose.
Molly Thompson has nothing to disclose.
|
|
|
|
Content Review |
|
Alexandra Novitsky, MD, has nothing to disclose.
|
|
|
Disclaimer |
|
This educational activity may contain discussion of published as well as investigational uses of agents that are not approved by the US Food and Drug Administration. For additional information about approved uses, including approved indications, contraindications, and warnings, please refer to the prescribing information for each product.
This activity has been designed to provide continuing education that is focused on specific objectives. In selecting educational activities, clinicians should pay special attention to the relevance of those objectives and the application to their particular needs. The intent of all Meniscus Educational Institute educational opportunities is to provide learning that will improve patient care. Clinicians are encouraged to reflect on this activity and its applicability to their own patient population.
The opinions expressed in this activity are those of the faculty and reviewers and do not represent an endorsement by Meniscus Educational Institute of any specific therapeutics or approaches to diagnosis or patient management.
|
|
|
Additional Resources |
|
Presentation Slides |
Question and Answer transcript
|
|
Instructions for Completion |
|
To receive credit for this unit, view the presentation. It will take approximately 30 minutes to complete. When you have finished, complete the evaluation. Upon completion of the evaluation form you will be able download your CME/CE certificate.
Clinicians who are not physicians or nurses will be provided a certificate of completion to submit for credit in accordance with their state board, specialty society, or other professional association.
|
|
|
Technical Requirements |
|
A computer with broadband internet access with cookies enabled, sound card and speakers are required. Our educational activities require the Adobe Flash Player. This browser plug-in is free, and available from the Adobe web site. Adobe PDF Reader is necessary to print your CME certificate. This browser plug-in is also free and available from the Adobe web site.
|
|
|
Fee Statement |
|
This enduring internet activity is FREE to all participants.
This activity is supported by an educational grant from Ikaria, Inc.
|
|
|
|