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RecruitingNCT07099144INOFTTONHRFWPHUpdated Aug 1, 2025

Inhaled Nitric Oxide for the Treatment of Neonatal Hypoxic Respiratory Failure With Pulmonary Hypertension

An observational study in Pulmonary Hypertension and Hypoxic Respiratory Failure, sponsored by Lee's Pharmaceutical Limited. Recruiting at 1 site in China. Open to participants aged Up to 7 Days. Per ClinicalTrials.gov, last updated 2025-08-01.

Sponsored by Lee's Pharmaceutical Limited · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
120
Ages
Up to 7 Days
Sex
All
01

Study summary

This is a prospective, open-label, single-arm, multicenter Phase IV clinical study to evaluate the safety of INOmax for the treatment of hypoxic respiratory failure with pulmonary hypertension in newborns (≥ 34 weeks gestational age). To evaluate the safety of INOmax combined with ventilatory support in the treatment of neonatal (≥ 34 weeks gestational age) hypoxic respiratory failure with pulmonary hypertension.

Read the detailed description

The study treatment will be administered in ventilated newborn infants expected to require support > 24 hours, after respiratory support has been optimized. This includes optimizing tidal volume/pressures and lung recruitment (surfactant, high frequency ventilation, and positive end expiratory pressure).

The administration of the study drug will be supervised by a physician investigator experienced in neonatal intensive care and used in clinics where neonatal artificial ventilation as well as rescue and resuscitation are available.

The starting dose of INOmax is 20 ppm, which is controlled by the INOmax DSIR Plus delivery system in the respiratory circuit during mechanical ventilation. The dose will be maintained at 20 ppm for 4 hours after the start of administration, then the dose can be weaned to 5 ppm provided that the arterial oxygenation is adequate, as determined by the investigator within 4-24 hours of therapy, and the therapy should be maintained at 5 ppm until the fraction of inspired oxygen (FiO2) \< 0.60.

The treatment will be maintained until the potential hypoxia is resolved, or the investigator determines that the neonate no longer needs to use this drug. The maintenance treatment time is usually less than 4 days (96 hours). If the oxygenation level has not improved significantly after 4 days of maintenance treatment, the suitability of the treatment plan should be reassessed. If it is necessary to continue using this drug after evaluation by the investigator, the maximum administration time should not exceed 14 days.

Doses greater than 20 ppm are not allowed. Monitoring

  1. Measure methemoglobin within 4-8 hours after initiation of treatment with INOmax and periodically throughout treatment.
  2. Prior to INOmax treatment, appropriate procedures must be followed to purify the nitrogen dioxide (NO2) system so that the NO2 concentration should always be less than 0.5 ppm and maintained as low as possible, if NO2 is greater than 0.5 ppm, the delivery system will be assessed for failure, the NO2 analyzer will be recalibrated, and the dose and/or FiO2 will be reduced appropriately.
  3. Monitor for inspired NO2 during INOmax administration.
02

Conditions studied

  • Pulmonary Hypertension
  • Hypoxic Respiratory Failure
03

Who can participate

Ages eligible
Up to 7 Days
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

120 neonates (gestational age ≥ 34 weeks) hypoxic respiratory failure with pulmonary hypertension.

The study treatment will be administered in ventilated newborn infants expected to require support > 24 hours, after respiratory support has been optimized. This includes optimizing tidal volume/pressures and lung recruitment (surfactant, high frequency ventilation, and positive end expiratory pressure).

The administration of the study drug will be supervised by a physician investigator experienced in neonatal intensive care and used in clinics where neonatal artificial ventilation as well as rescue and resuscitation are available.

Inclusion criteria

  1. Neonates ≥ 34 weeks gestation age.
  2. Hypoxic respiratory failure requiring more than 24 hours of ventilatory support.
  3. Clinical or echocardiographic evidence of pulmonary hypertension (systolic pulmonary arterial pressure [sPAP] > 35 mm Hg or > 2/3 systemic blood pressure [SBP] or there is a right-to-left shunt at the atrium or arterial ductus).
  4. Age less than 7 days at the time of treatment initiation with study drug.
  5. The neonatal guardian agrees to participate in the study and signs an informed consent form (ICF).

Exclusion criteria

Exclusion Criteria:

  1. Neonates dependent on right-to-left shunting of blood.
  2. Neonates whose mother has been treated with anticoagulant therapies during pregnancy.
  3. Echocardiography confirmed left-to-right shunt or left ventricular dysfunction.
  4. ECMO is urgently needed, or neonate has received ECMO.
  5. Patient is at risk of imminent death (death expected within 24 hours).
  6. Life-threatening abnormality (cranial, cardiac, thoracic).
  7. Chromosomal abnormality.
  8. Congenital diaphragmatic hernia
  9. Congenital heart defect (other than patent ductus arteriosus or small atrial septal defect).
  10. Neonate has been resuscitated requiring chest compressions within 6 hours of study treatment start.
  11. Significant bleeding diathesis such as grade IV intraventricular hemorrhage or periventricular leukomalacia, pulmonary hemorrhage, uncontrolled bleeding or hemodynamic failure.
  12. Disseminated intravascular coagulopathy.
  13. Active seizures while receiving anticonvulsants.
  14. Experienced prolong asphyxia with evidence of severe acidosis (pH\<7.25)
  15. Receiving nitric oxide donor agents such as prilocaine, sodium nitroprusside, nitroglycerin, and sulfonamides.
  16. Other subjects determined by the investigator to be unsuitable for inclusion.
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
120 participants (estimated)
Patient registry
No
Biospecimen retention
Samples without dna

Groups and cohorts

  • inhaled nitric oxide combined with ventilatory support

    Drug: Inhaled nitric oxide (NO)

Interventions

  • DrugInhaled nitric oxide (NO)

    The starting dose of INOmax is 20 ppm, which is controlled by the INOmax DSIR Plus delivery system in the respiratory circuit during mechanical ventilation. The dose will be maintained at 20 ppm for 4 hours after the start of administration, then the dose can be weaned to 5 ppm provided that the arterial oxygenation is adequate, as determined by the investigator within 4-24 hours of therapy, and the therapy should be maintained at 5 ppm until the fraction of inspired oxygen (FiO2) \< 0.60. The treatment will be maintained until the potential hypoxia is resolved, or the investigator determines that the neonate no longer needs to use this drug. The maintenance treatment time is usually less than 4 days (96 hours). If the oxygenation level has not improved significantly after 4 days of maintenance treatment, the suitability of the treatment plan should be reassessed.

05

What researchers measure

Primary outcomes

  1. To evaluate the safety of inhaled nitric oxide combined with ventilatory support in the treatment of neonatal (≥ 34 weeks gestational age) hypoxic respiratory failure with pulmonary hypertension.

    Incidence and severity of all treatment emergent adverse events (TEAEs). Incidence of drug-related serious AEs (SAEs). Incidence of AEs of special interest (AESI).

    Time frame: Adverse events that occured during the study, not more than 14 days. Blood routine, blood biochemistry, blood gas analysis, chest X-ray and echocardiography will be performed at the screening and through study completion, not more than 14 days.

06

Study locations

1 of 1 sites recruiting
  • Guangzhou Women and Children'S Medical Center
    Guangzhou, Guangdong 510623, China
    Recruiting
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07099144
Lead sponsor
Lee's Pharmaceutical Limited
Responsible party
Sponsor
First posted
Aug 1, 2025
Start date
Dec 12, 2024
Primary completion
Dec 31, 2025 (estimated)
Completion
Dec 30, 2026 (estimated)
Last update
Aug 1, 2025

Study contacts

Wen hao Zhou
Contact
zwhchfu@126.com
+86-18017591123

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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