Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator approved for treating term and near-term neonates with hypoxic respiratory failure. iNO works by dilating pulmonary vessels, improving ventilation-perfusion matching, and reducing pulmonary hypertension. Upon inhalation, iNO rapidly reacts with oxygen and water in the lungs to produce nitrogen dioxide and nitrate. As these breakdown products are not lipid soluble, iNO has very little ability to enter the bloodstream and cause systemic vasodilation. This selective pulmonary vasodilation allows iNO to significantly improve oxygenation without worsening ventilation/perfusion mismatching or causing systemic hypotension in neonates with hypoxic respiratory failure.
Market Dynamics:
The global inhaled nitric oxide market growth is driven by the rising incidence of preterm births and respiratory distress syndrome among neonates. For Instance, in May 2025, according to the data reported by World Health Organization, prematurity is the leading cause of death among children under 5 years of age. Preterm birth complications caused around 900,000 child deaths in 2020, with 75% preventable through cost-effective interventions; global preterm birth rates in 2020 ranged from 4–16%. Moreover, inhaled nitric oxide has been increasingly recommended as the first-line therapy for hypoxic respiratory failure in newborns by leading clinical practice guidelines, thereby fuelling its adoption. However, the market growth can be restrained by the exorbitant price of iNO delivery systems and cylinders. On the other hand, ongoing research on the efficacy of iNO in other lung conditions like acute respiratory distress syndrome (ARDS) in adults presents lucrative opportunities for market expansion.
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