Sun Bo
Departments of Pediatrics and Neonatology, Children's Hospital of Fudan University and Laboratory of Neonatal Medicine of Ministry of Health, Shanghai, China.
J Matern Fetal Neonatal Med. 2012 Apr;25 Suppl 1:51-4. doi: 10.3109/14767058.2012.665243. Epub 2012 Mar 13.
Inhaled nitric oxide (iNO) has been used not only for pulmonary vasodilation in term neonates with hypoxemic respiratory failure, but also in preterm ones at risk of chronic lung disease (CLD) with variable results in prevention and treatment of CLD and/or brain injury. However, meta analysis of clinical trials does not support that iNO should be used routinely in preterm infants with hypoxic respiratory failure as it has no convincing long-term follow-up data to show its advantages in neurodevelopment. Investigation of extra-pulmonary effects of iNO through nitrosothiol hemoglobin-associated hypoxic vasodilation, as well as its intra- and extra-pulmonary anti-inflammation effect, would have biological and physiological potential in the management of the lung and brain injury of prematurity. The eligibility and safety of iNO in these premature infants at high risk of neurodevelopmental disability require more clinical and follow-up effort to test its pharmacological benefit over harm.
吸入一氧化氮（iNO）不仅用于足月低氧性呼吸衰竭新生儿的肺血管舒张，也用于有慢性肺病（CLD）风险的早产儿，在预防和治疗CLD和/或脑损伤方面效果不一。然而，临床试验的荟萃分析并不支持iNO应常规用于低氧性呼吸衰竭的早产儿，因为没有令人信服的长期随访数据表明其在神经发育方面的优势。通过亚硝基硫醇血红蛋白相关的低氧血管舒张来研究iNO的肺外效应，以及其肺内和肺外抗炎作用，在早产相关的肺和脑损伤管理中具有生物学和生理学潜力。iNO在这些有神经发育障碍高风险的早产儿中的适用性和安全性需要更多的临床和随访工作来检验其药理利弊。
