Kinsella John P
The Children's Hospital/University of Colorado School of Medicine, Denver, Colorado 80218, USA.
Curr Opin Pediatr. 2006 Apr;18(2):107-11. doi: 10.1097/01.mop.0000193291.09894.6c.
Inhaled nitric oxide therapy reduces the need for extracorporeal membrane oxygenation in near-term and term newborns with hypoxemic respiratory failure and persistent pulmonary hypertension, and is now a standard of care for this population. There is also considerable interest, however, in the potential role of inhaled nitric oxide in premature newborns with hypoxemic respiratory failure. The purpose of this review is to summarize the results of clinical trials of inhaled nitric oxide in premature newborns, with particular emphasis on studies published in the last 12 months.
Several trials of inhaled nitric oxide in premature newborns with respiratory failure have been published in the last year. Interpretation of the findings is complicated by differences in the severity of illness of the study populations, the trial designs, and relevant outcome measures recorded.
Trials of inhaled nitric oxide in premature newborns have yielded conflicting results to date, and the role of inhaled nitric oxide therapy in this population remains controversial. The largest trials of inhaled nitric oxide therapy in premature newborns have completed enrollment but have yet to be published. The results of these ongoing trials will help clarify the potential risks and benefits of inhaled nitric oxide therapy in the premature newborn.
吸入一氧化氮疗法可减少患有低氧性呼吸衰竭和持续性肺动脉高压的近足月及足月新生儿对体外膜肺氧合的需求,现已成为该人群的标准治疗方法。然而,人们也相当关注吸入一氧化氮在患有低氧性呼吸衰竭的早产新生儿中的潜在作用。本综述的目的是总结早产新生儿吸入一氧化氮临床试验的结果,特别强调过去12个月发表的研究。
去年发表了几项关于早产新生儿呼吸衰竭吸入一氧化氮的试验。研究人群疾病严重程度、试验设计以及记录的相关结局指标的差异使研究结果的解读变得复杂。
迄今为止,早产新生儿吸入一氧化氮的试验结果相互矛盾,吸入一氧化氮疗法在该人群中的作用仍存在争议。早产新生儿吸入一氧化氮疗法的最大规模试验已完成入组,但尚未发表。这些正在进行的试验结果将有助于阐明早产新生儿吸入一氧化氮疗法的潜在风险和益处。