O2 and NO – Time for a Divorce or a Reconciliation?

Monday, April 28, 2025

9:15am – 10:45am HST

Location: Convention Center: Kalākaua Ballroom C (Level 4)

CE: 1.5

Selected By: Neonatal

Chair(s)

Shyamala Dakshinamurti, MD MSc (she/her/hers)

Professor, Pediatrics and Physiology
Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba
Winnipeg, Manitoba, Canada
Steve Abman, MD (he/him/his)

Professor
University of Colorado School of Medicine
Denver, Colorado, United States

Disclosure(s):

Shyamala Dakshinamurti, MD MSc: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Steve Abman, MD: Chiesi (Ongoing) (Products/Services: Consultant)

A decade after the PAS session “O2 and NO: Marriage Made in Heaven or Hell”, we revisit the relationship. Use of 100% O2 and NO together is commonplace; NO is a first-line pulmonary vasodilator and a modifier of ventilator-induced lung injury. But the more we learn about oxidative and nitrosative stress in the pulmonary circuit, and the biochemical causes of NO response failure, the more we worry about how much to turn up the dial, and when. This session examines the biology of the NO response and the role of oxygen targeting in pulmonary hypertension and chronic lung disease. Maybe it’s not time for a restraining order – but definitely time for some counselling!

Learning Objectives:

Describe current clinical practice for oxygen targeting in neonates with hypoxic respiratory failure treated with inhaled nitric oxide
Understand physiological benefits and risks of oxidative and nitrosative stress in the pulmonary circulation
Identify management strategies to safely dial up oxygen and nitric oxide, and alternative approaches to avoid treatment failure

Presentations:

9:15am – 9:30am HST

Swiping Right, Every Time: The Coincidence of NO and Hyperoxia in Pulmonary Hypertension Management
Speaker: Janneke Dekker, RN PhD (she/her/hers) – Leiden University Medical Center
9:30am – 9:45am HST

Are We Flirting with Trouble? Oxygen Targeting and the Response to NO
Speaker: Satyan Lakshminrusimha, MD (he/him/his) – UC Davis
9:45am – 10:05am HST

It's Not You, It's Me... Preserving Nitroso Signals in Hyperoxic Lung Disease
Speaker: Thomas M. Raffay, MD (he/him/his) – UH Rainbow Babies & Children's Hospital
10:05am – 10:25am HST

Signs You're in a Toxic Relationship: Dangers of NO in an Oxidized Environment
Speaker: Shyamala Dakshinamurti, MD MSc (she/her/hers) – Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba
10:25am – 10:45am HST

Can This Marriage Be Saved? Balancing O2 and NO, and Reactivating NO Targets
Speaker: Steve Abman, MD (he/him/his) – University of Colorado School of Medicine