de Mol Amerik C, van Heijst Arno F J, de Haan Ton F J, van der Staak Frans H J M, Liem Kian D
Department of Neonatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
ASAIO J. 2009 May-Jun;55(3):213-6. doi: 10.1097/MAT.0b013e31819901a5.
This study evaluated the relation between prior inhaled nitric oxide (iNO) and the time to initiation and duration of treatment with veno-arterial extracorporeal membrane oxygenation (ECMO) and the occurrence of hemorrhagic complications. A retrospective study was conducted in 59 human newborns treated for respiratory insufficiency with ECMO over a 5-year period. Patients received iNO before ECMO (iNO group) or not (control group). Both groups were compared for patient characteristics, postnatal age at the initiation of ECMO, duration of ECMO treatment, and hemorrhagic complications. There were no significant differences between the iNO group and the control group for patient characteristics and medication use before the ECMO treatment, except for norepinephrine. There was no significant difference for postnatal age at the initiation of ECMO and mean duration of ECMO treatment. We found no statistically significant difference in hemorrhagic complications between both groups. This persisted after correction for diagnosis and ECMO run-time in linear logistic regression analysis. Inhaled nitric oxide before ECMO did not result in a significant delay in the initiation of ECMO or longer duration of the ECMO. There was no significant relationship between the use of prior iNO and the occurrence of hemorrhagic complications during the ECMO treatment.
本研究评估了既往吸入一氧化氮（iNO）与静脉-动脉体外膜肺氧合（ECMO）治疗开始时间、治疗持续时间以及出血并发症发生之间的关系。对59例在5年期间接受ECMO治疗呼吸功能不全的人类新生儿进行了一项回顾性研究。患者在ECMO治疗前接受iNO治疗（iNO组）或未接受（对照组）。比较两组患者的特征、ECMO开始时的出生后年龄、ECMO治疗持续时间以及出血并发症。除去甲肾上腺素外，iNO组和对照组在ECMO治疗前的患者特征和用药情况方面无显著差异。ECMO开始时的出生后年龄和ECMO治疗平均持续时间无显著差异。我们发现两组在出血并发症方面无统计学显著差异。在线性逻辑回归分析中对诊断和ECMO运行时间进行校正后，这种情况仍然存在。ECMO治疗前吸入一氧化氮并未导致ECMO开始时间显著延迟或ECMO持续时间延长。既往使用iNO与ECMO治疗期间出血并发症的发生之间无显著关系。
