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新生儿期吸入一氧化氮的应用:来自欧洲吸入一氧化氮注册研究的结果。

Use of inhaled nitric oxide in the new born period: results from the European Inhaled Nitric Oxide Registry.

机构信息

Liverpool Women's Hospital, Liverpool, UK.

出版信息

Acta Paediatr. 2010 Jun;99(6):854-60. doi: 10.1111/j.1651-2227.2010.01722.x. Epub 2010 Mar 5.

Abstract

AIMS

The aim of this study was to present data relating to the use of inhaled nitric oxide (iNO) in newborn infants included in the European Inhaled Nitric Oxide Registry.

METHODS

Demographic, clinical and therapeutic data from seven European centres are reported. Univariate analyses were performed to identify factors associated with acute response to iNO and survival without extra corporeal membrane oxygenation (ECMO).

RESULTS

A total of 112 newborn infants received iNO, with 40% being less than 34 weeks gestational age. The commonest indication for iNO was secondary pulmonary hypertension. Acute response to iNO was more common in infants with a higher oxygenation index (median OI 32.7 vs 22.6, p = 0.040), although acute response did not predict survival without ECMO. Infants who survived without ECMO had a lower OI prior to therapy (median OI 24 vs 43, p = 0.009), were commenced on a higher starting dose (median dose 20 ppm vs 10 ppm p = 0.013) and received a lower maintenance dose (median dose 10 vs 17 ppm, p = 0.027) than those who died or received ECMO.

CONCLUSION

Collating and reporting data about iNO therapy in neonates across a number of European centres using a web-based system is feasible. These data may be used to monitor the clinical use of iNO, identify adverse effects, generate research hypotheses and promote high standards in the clinical use of iNO.

摘要

目的

本研究旨在介绍欧洲吸入一氧化氮(iNO)登记处中纳入的新生儿使用吸入一氧化氮的数据。

方法

报告了来自 7 个欧洲中心的人口统计学、临床和治疗数据。进行了单变量分析,以确定与 iNO 急性反应和无体外膜氧合(ECMO)存活相关的因素。

结果

共有 112 名新生儿接受了 iNO 治疗,其中 40%的新生儿胎龄小于 34 周。iNO 的常见适应证为继发性肺动脉高压。iNO 治疗急性反应在氧合指数较高的婴儿中更为常见(中位数 OI 为 32.7 与 22.6,p = 0.040),尽管急性反应不能预测无 ECMO 存活。无 ECMO 存活的婴儿在治疗前的氧合指数较低(中位数 OI 为 24 与 43,p = 0.009),起始剂量较高(中位数剂量为 20 ppm 与 10 ppm,p = 0.013),维持剂量较低(中位数剂量为 10 与 17 ppm,p = 0.027)。

结论

使用基于网络的系统在多个欧洲中心收集和报告关于新生儿 iNO 治疗的数据是可行的。这些数据可用于监测 iNO 的临床应用,识别不良反应,生成研究假设,并促进 iNO 的临床应用高标准。

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