Method of identifying and treating premature infants at risk for BPD

A method of avoiding risks associated with administration of inhaled nitric oxide to premature infants at risk for developing bronchopulmonary dysplasia comprising:

• a) testing the premature infant for one or more of
• (i) a plasma total concentration of nitrate and nitrite;
• (ii) a concentration of nitric oxide in exhaled ambient or nitric oxide-free air;
• and
• (iii) presence of a genetic mutation in a gene encoding endothelial nitric oxide synthase (eNOS gene) in a blood or tissue sample that results in decrease endogenous synthesis of nitric oxide;
• b) determining whether the total concentration of nitrate and nitrite in the plasma is at least about 50 μM, whether the concentration of nitric oxide in the exhaled air is about 2.5 ppb or higher and/or whether no genetic mutation in the eNOS gene that reduces endogenous synthesis of nitric oxide is present;
• c) treating the premature infant only with non-inhaled nitric oxide modalities to reduce the likelihood of development of bronchopulmonary dysplasia if the total concentration of nitrate and nitrite in the plasma is at least about 50 μM, the concentration of nitric oxide in the exhaled air is about 2.5 ppb or higher, and/or the genetic mutation is not present;
• and
• d) treating the premature infant with inhaled nitric oxide to reduce the likelihood of development of bronchopulmonary dysplasia when the total concentration of nitrate and nitrite in the plasma is less than about 50 μM, when the measured concentration of nitric oxide in the exhaled air is less than about 1.5 ppb, and/or when the genetic mutation is present,
• wherein the premature infant is less than 30 weeks gestational age.