Bartley Bethany L, Gardner Kelly J, Spina Stefano, Hurley Bryan P, Campeau David, Berra Lorenzo, Yonker Lael M, Carroll Ryan W
Department of Pediatric Pulmonology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
The Mucosal Immunology and Biology Research Center, Massachusetts General Hospital East, 16 Street, Charlestown, MA 02129, USA.
Case Rep Pediatr. 2020 Jun 24;2020:1536714. doi: 10.1155/2020/1536714. eCollection 2020.
Individuals with cystic fibrosis (CF) have persistent lung infections, necessitating the frequent use of antibiotics for pulmonary exacerbations. Some respiratory pathogens have intrinsic resistance to the currently available antibiotics, and any pathogen may acquire resistance over time, posing a challenge to CF care. Gaseous nitric oxide has been shown to have antimicrobial activity against a wide variety of microorganisms, including common CF pathogens, and offers a potential inhaled antimicrobial therapy. . Here, we present the case of a 16-year-old female with CF who experienced a precipitous decline in lung function over the prior year in conjunction with worsening antibiotic resistance of her primary pathogen, . She received 46 intermittent inhalations of 160 parts-per-million nitric oxide over a 28-day period. The gas was administered via a mechanical ventilator fitted with nitrogen dioxide scavenging chambers.
High-dose inhaled nitric oxide was safe, well tolerated, and showed clinical benefit in an adolescent with cystic fibrosis and pulmonary colonization with .
囊性纤维化（CF）患者存在持续性肺部感染，因此在肺部病情加重时需要频繁使用抗生素。一些呼吸道病原体对目前可用的抗生素具有内在抗性，并且任何病原体都可能随着时间的推移获得抗性，这给CF治疗带来了挑战。气态一氧化氮已被证明对多种微生物具有抗菌活性，包括常见的CF病原体，并提供了一种潜在的吸入性抗菌疗法。在此，我们报告一例16岁CF女性患者，其在过去一年中肺功能急剧下降，同时其主要病原体的抗生素耐药性不断恶化。在28天的时间里，她接受了46次160ppm一氧化氮的间歇性吸入治疗。该气体通过配备二氧化氮清除室的机械通气机给药。
高剂量吸入一氧化氮安全、耐受性良好，并且在一名患有囊性纤维化并伴有肺部定植的青少年患者中显示出临床益处。
