Hosono Shigeharu, Ohno Tutomu, Kimoto Hirofumi, Shimizu Masaki, Takahashi Shigeru, Harada Kensuke
Nihon University School of Medicine, Itabashi Hospital, Tokyo, Japan and Saitama Children's Medical Center, Saitama, Japan.
J Perinat Med. 2006;34(4):333-7. doi: 10.1515/JPM.2006.064.
To determine whether inhaled nitric oxide might reduce the need for excessive respiratory alkalosis to maintain systemic oxygenation in infants with persistent pulmonary hypertension of the newborn (PPHN).
A retrospective historical cohort study of 34 infants with PPHN with oxygenation index (OI) of 25 or more, including 19 infants without inhaled nitric oxide (i-NO) therapy (control group) and 15 infants with inhaled nitric oxide therapy (i-NO group) was performed. The initial dose of 10 ppm of i-NO was administered and no responders received the maximum dose of 25 ppm. We evaluated the mortality rate and the change of OI index and PaCO(2) during the first 6 days.
There were no significant differences in characteristics between groups. Two of 15 in the i-NO group and 6 of 19 infants in the control group died during the first 48 h. Baseline OI, PaCO(2) and arterial pH were similar in the two groups. OI in the i-NO group was significantly higher than in the control group between 12 and 96 h. PaCO(2) in the i-NO group was higher than in the control group between 24 and 144 h.
i-NO therapy for PPHN might improve systemic oxygenation without excessive hypocapnia. However there was no reduction in duration of ventilation support or oxygen supply.
确定吸入一氧化氮是否可减少患有新生儿持续性肺动脉高压（PPHN）的婴儿为维持全身氧合而过度呼吸性碱中毒的需求。
对34例氧合指数（OI）为25或更高的PPHN婴儿进行回顾性历史队列研究，其中包括19例未接受吸入一氧化氮（i-NO）治疗的婴儿（对照组）和15例接受吸入一氧化氮治疗的婴儿（i-NO组）。给予初始剂量为10 ppm的i-NO，无反应者接受最大剂量25 ppm。我们评估了前6天的死亡率以及OI指数和PaCO₂的变化。
两组之间在特征方面无显著差异。i-NO组15例中有2例，对照组19例中有6例在最初48小时内死亡。两组的基线OI、PaCO₂和动脉pH相似。i-NO组在12至96小时之间的OI显著高于对照组。i-NO组在24至144小时之间的PaCO₂高于对照组。
PPHN的i-NO治疗可能改善全身氧合而无过度低碳酸血症。然而，通气支持或氧气供应的持续时间并未缩短。
