Wirbelauer J, Speer C P
University Hospital, University Children's Hospital, Josef-Schneider-Strasse 2, Würzburg.
Klin Padiatr. 2010 Mar;222(2):56-61. doi: 10.1055/s-0029-1243614. Epub 2010 Feb 19.
In 2001, NO was approved as a therapeutic agent in Europe for the treatment of persistent pulmonary hypertension in late preterm infants >34 weeks of gestational age and term newborns. Recent observational studies suggest, that preterm infants <34 weeks of gestation with acute hypoxic lung failure could benefit from inhaled NO (iNO) by improved oxygenation. To date, 21 randomised-controlled trials have enrolled 3 336 preterm infants <34 weeks of gestation for iNO treatment. Overall, iNO treatment does not reduce the rate of bronchopulmonary dysplasia (BPD) or death compared to controls. In addition, iNO treatment of preterm infants with hypoxic respiratory failure or increased risk of BPD does not affect the combined incidence of death and BPD. However, early prophylactic use of iNO in preterm infants with respiratory distress seems to improve survival without BPD or severe cerebral damage. Current data of long term neurological outcome of iNO-treated preterm infants do not seem to justify iNO administration. Outside of well designed clinical trials iNO-treatment of preterm infants can currently not be recommended.
2001年，一氧化氮（NO）在欧洲被批准作为一种治疗药物，用于治疗胎龄大于34周的晚期早产儿和足月儿的持续性肺动脉高压。最近的观察性研究表明，胎龄小于34周且患有急性低氧性肺衰竭的早产儿可能会因吸入一氧化氮（iNO）改善氧合而受益。迄今为止，已有21项随机对照试验纳入了3336名胎龄小于34周的早产儿进行iNO治疗。总体而言，与对照组相比，iNO治疗并未降低支气管肺发育不良（BPD）的发生率或死亡率。此外，对患有低氧性呼吸衰竭或BPD风险增加的早产儿进行iNO治疗，并不影响死亡和BPD的合并发生率。然而，对有呼吸窘迫的早产儿早期预防性使用iNO似乎可提高无BPD或严重脑损伤情况下的生存率。目前关于接受iNO治疗的早产儿长期神经学转归的数据似乎并不支持使用iNO。在精心设计的临床试验之外，目前不建议对早产儿进行iNO治疗。
