Chotigeat Uraiwan, Khorana Meera, Kanjanapatakul Wiboon
Department of Pediatrics, Queen Sirikit National Institute of Child Health, Bangkok, Thailand.
J Med Assoc Thai. 2002 Jul;85(7):800-7.
This study assessed the outcome of nitric oxide treatment in infants with persistent pulmonary hypertension of the newborn (PPHN) who failed high frequency oscillatory ventilation (HFOV).
This study was conducted from July 1, 2000 to June 30, 2001 at the neonatal intensive care unit of Queen Sirikit National Institute of Child Health. Nitric oxide was administered to 20 infants, > or = 34 weeks gestational age who were diagnosed with PPHN and had two oxygenation index > or = 20 at least 30 minutes apart after HFOV treatment.
Nitric oxide inhalation significantly improved the oxygenation index, a/A ratio, A-a gradient (p<0.05) and directly measured partial pressure arterial oxygenation. Oxygen saturation improved within ten minutes after nitric oxide inhalation. The survival rate was 85 per cent. Meconium aspiration syndrome was the most common cause of PPHN. No acute complication was found during nitric oxide administration.
Inhalation of nitric oxide increased the blood oxygen tension of infants with PPHN without using a surfactant and ECMO. The authors suggest that inhalation nitric oxide is a useful adjunctive therapy for these patients.
本研究评估了一氧化氮治疗对高频振荡通气（HFOV）失败的新生儿持续性肺动脉高压（PPHN）患儿的疗效。
本研究于2000年7月1日至2001年6月30日在诗丽吉王后国家儿童健康研究所新生儿重症监护病房进行。对20例胎龄≥34周、诊断为PPHN且在HFOV治疗后至少间隔30分钟两次氧合指数≥20的婴儿给予一氧化氮治疗。
吸入一氧化氮显著改善了氧合指数、a/A比值、A-a梯度（p<0.05）以及直接测量的动脉血氧分压。一氧化氮吸入后10分钟内血氧饱和度改善。存活率为85%。胎粪吸入综合征是PPHN最常见的病因。一氧化氮给药期间未发现急性并发症。
吸入一氧化氮可在不使用表面活性剂和体外膜肺氧合（ECMO）的情况下提高PPHN患儿的血氧张力。作者认为吸入一氧化氮对这些患者是一种有用的辅助治疗方法。
