Nakagawa T A, Johnston S J, Falkos S A, Gomez R J, Morris A
Department of Pediatrics, Children's Hospital of The King's Daughters, EasternVirginia Medical School, Norfolk 23507, USA.
J Pediatr. 2000 Jul;137(1):119-22. doi: 10.1067/mpd.2000.106232.
Inhaled nitric oxide (NO) was administered to 5 consecutive children with life-threatening status asthmaticus who required mechanical ventilation and did not respond to maximal medical management. Four showed a >20% decrease in baseline PaCO(2) (median PaCO(2) = 154 mm Hg, range = 95 to 229 mm Hg) occurring rapidly after the administration of inhaled NO. Three children, in addition to the index case, received continuous inhaled NO therapy, ranging from 5.5 to 21.5 hours. Systemic hypotension was not observed, and the maximum methemoglobin level was 1.9%. Four children survived to hospital discharge. Although the precise mechanism of action is not known, it appears that inhaled NO merits further study and may represent a life-saving therapy in this select patient population.
对5名患有危及生命的哮喘持续状态且需要机械通气、对最大程度的药物治疗无反应的儿童连续给予吸入一氧化氮（NO）。4名儿童在吸入NO后，基线动脉血二氧化碳分压（PaCO₂）迅速下降>20%（PaCO₂中位数=154mmHg，范围=95至229mmHg）。除首例病例外，3名儿童接受了持续5.5至21.5小时的吸入NO治疗。未观察到系统性低血压，高铁血红蛋白最高水平为1.9%。4名儿童存活至出院。尽管确切的作用机制尚不清楚，但吸入NO似乎值得进一步研究，可能是这一特定患者群体的一种挽救生命的疗法。
