Hoehn T, Krause M F, Bührer C
Klinik für Neonatologie, Charité, Virchow-Klinikum, Humboldt-Universität, Berlin.
Klin Padiatr. 2000 Mar-Apr;212(2):47-52. doi: 10.1055/s-2000-9651.
According to a number of recently published, randomized controlled trials, treatment of persistent pulmonary hypertension of the newborn (PPHN) by the use of inhaled nitric oxide (iNO) has emerged as an established procedure in neonatology. The situation in premature infants appears to be more complicated than in the term infant. Due to the fact that nitric oxide interferes with platelet aggregation, the risk of intraventricular hemorrhage or its aggravation during iNO therapy is being discussed in a controversial manner. Since most studies are aimed at endpoints like oxygenation parameters, the presently available studies report extremely variable incidences of intraventricular hemorrhages (IVH). Meanwhile two large studies could demonstrate that clinical application of iNO in preterm infants is not associated with an increased incidence of IVH. Further randomized controlled trials of iNO in preterm neonates are highly desirable in order to establish the future role of this therapy and its indications.
根据最近发表的一些随机对照试验，使用吸入一氧化氮（iNO）治疗新生儿持续性肺动脉高压（PPHN）已成为新生儿学中的既定程序。早产儿的情况似乎比足月儿更复杂。由于一氧化氮会干扰血小板聚集，因此在iNO治疗期间脑室内出血或其加重的风险一直存在争议。由于大多数研究针对的是氧合参数等终点，目前可用的研究报告脑室内出血（IVH）的发生率差异极大。与此同时，两项大型研究表明，iNO在早产儿中的临床应用与IVH发生率增加无关。为了确定这种疗法的未来作用及其适应症，非常需要对早产儿进行进一步的iNO随机对照试验。
