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[一氧化氮吸入治疗新生儿肺动脉高压]

[Nitric oxide inhalation in newborn infants with pulmonary hypertension].

作者信息

de Beaufort A J, Slot H M, van Bel F

机构信息

Academisch Ziekenhuis, afd. Neonatologie, Leiden.

出版信息

Ned Tijdschr Geneeskd. 1998 Jan 17;142(3):123-7.

PMID:9557009
Abstract

Nitric oxide (NO) is an important endogenous vasodilator. NO, produced in the endothelial cell, causes vasodilation by relaxation of the vascular smooth muscle cell. Inhalation of NO plays a role in the treatment of persistent pulmonary hypertension of the newborn, a syndrome with considerable morbidity and mortality. NO inhalation specifically leads to pulmonary vasodilation without systemic hypotension, since NO binds avidly to haemoglobin. Neonates with pulmonary hypertension associated with lung hypoplasia, meconium aspiration syndrome, infantile inspiratory distress syndrome due to surfactant deficiency, and sepsis have been treated with inhaled NO. Literature data on NO inhalation and experience in our units with NO inhalation show an improvement in arterial oxygen tension and a decreased need for extracorporeal membrane oxygenation, but no reduction in mortality. NO toxicity as a result of NO inhalation in the newborn has not been reported yet.

摘要

一氧化氮(NO)是一种重要的内源性血管舒张剂。由内皮细胞产生的NO通过使血管平滑肌细胞松弛而导致血管舒张。吸入NO在新生儿持续性肺动脉高压的治疗中发挥作用,这是一种具有相当高发病率和死亡率的综合征。由于NO与血红蛋白有很强的结合力,吸入NO可特异性地导致肺血管舒张而无全身低血压。患有与肺发育不全、胎粪吸入综合征、因表面活性剂缺乏导致的婴儿呼吸窘迫综合征以及败血症相关的肺动脉高压的新生儿已接受吸入NO治疗。关于吸入NO的文献数据以及我们单位使用吸入NO的经验表明,动脉血氧张力有所改善,对体外膜肺氧合的需求减少,但死亡率并未降低。尚未有关于新生儿吸入NO导致NO毒性的报道。

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