Medical Policy Inhaled Nitric Oxide in Newborns

1. Technology Assessment Nitric Oxide inhalation (iNO) therapy is a noninvasive treatment for PPHN that involves inhalation of gaseous nitric oxide in conjunction with ventilator support. The potential of exogenous NO as a therapeutic agent is based on its potent vasodilator properties and its ability to be delivered as a gas to the lung. Exogenous NO increases the partial pressure of arterial oxygen by dilating pulmonary vessels in better ventilated areas of the lung. NO inhalation therapy, in conjunction with ventilatory support, has been investigated for the treatment of term and near-term newborns, ≥ 34 weeks gestational age, with hypoxic respiratory failure associated with clinical or echocardiographic evidence of pulmonary hypertension.