Soraisham Amuchou S, Harabor Andrei, Shivananda Sandesh, Alvaro Ruben, Ye Xiang Y, Lee Shoo K, Shah Prakesh S
Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Am J Perinatol. 2016 Jun;33(7):715-22. doi: 10.1055/s-0036-1571329. Epub 2016 Feb 18.
Objective To determine the proportion of infants who receive inhaled nitric oxide (iNO), and to characterize the variations in its use by gestational age (GA) and center in infants <34 weeks' gestation. Design Retrospective analysis was performed in infants born at <34 weeks' gestation and admitted to neonatal intensive care units participating in the Canadian Neonatal Network between January 2010 and December 2013. Results Of 19,525 infants, 831 (4.2%) received iNO. A total of 369 infants (44%) received iNO during the first 2 days after birth. The proportion of neonates who received iNO in the 22 to 25, 26 to 29, and 30 to 33 weeks' GA groups was 16.1, 6.0, and 1.3%, respectively. Infants in whom iNO was initiated in the first 2 days of age received it for a shorter duration (median, 3 days; interquartile range [IQR], 2-5) as compared with those who started after 2 days (median, 5 days; IQR, 2-11). The use of iNO varied by center, ranging from 0 to 15.5% (p < 0.001). Conclusion Out of every 25 infants born at <34 weeks' gestation in Canada received iNO, with the highest rate of use in infants born at lower gestation. Further research to identify reasoning, efficacy, and safety of iNO in preterm infants is warranted.
目的 确定接受吸入一氧化氮（iNO）治疗的婴儿比例，并描述胎龄（GA）<34周的婴儿使用iNO的差异以及不同中心的使用情况。 设计 对2010年1月至2013年12月期间在加拿大新生儿网络参与研究的新生儿重症监护病房收治的胎龄<34周的婴儿进行回顾性分析。 结果 在19525例婴儿中，831例（4.2%）接受了iNO治疗。共有369例婴儿（44%）在出生后头2天内接受了iNO治疗。胎龄在22至25周、26至29周和30至33周组中接受iNO治疗的新生儿比例分别为16.1%、6.0%和1.3%。出生后头2天开始使用iNO的婴儿使用时间较短（中位数为3天；四分位间距[IQR]为2至5天），而出生2天后开始使用的婴儿使用时间较长（中位数为5天；IQR为2至11天）。iNO的使用因中心而异，范围从0至15.5%（p<0.001）。 结论 在加拿大，每25例胎龄<34周出生的婴儿中就有1例接受iNO治疗，胎龄越小的婴儿使用率越高。有必要进一步研究以确定iNO在早产儿中的使用原因、疗效和安全性。
