Inhaled Nitric Oxide in Preterm Neonates with Refractory Hypoxemia Associated to Oligohydramnios

Socarras, Jorge Luis Alvarado; Castro, J.; Díaz-Quijano, Fredi Alexander

doi:10.2174/1570163814666171017162730

Cited by 7 publications

(6 citation statements)

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“…Two died of hemorrhage in the lungs secondary to the ductus arteriosus, and the other died of pneumonia. Thus, iNO therapy is available for a subsection of high-risk episodes of prematurity due to hypoxemia, but not widely used [ 2 ]. Pan et al investigated the clinical efficacy of intratracheal infusion of pulmonary surfactant (PS) combined with budesonide in the prevention of bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) infants.…”

Section: Introductionmentioning

confidence: 99%

[Retracted] Profound Effect of Pulmonary Surfactant on the Treatment of Preterm Infants with Respiratory Distress Syndrome

Liu

Deng

2022

Contrast Media & Molecular Imaging

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Inherited diseases caused by dysfunction of pulmonary surfactant metabolism or surfactant dysfunction have recently been considered the underlying causes of neonatal and pediatric respiratory diseases. Respiratory distress syndrome in premature infants is a common respiratory disease in pediatrics. It is caused by underdeveloped lungs in infants and a lack of active substances on the surface of the alveoli, which leads to insufficiency of lung function, which can lead to difficulty breathing, increased heart rate, facial bruising, and more. Neonatal Respiratory Distress Syndrome is a very dangerous disease with a high mortality rate and a great threat to children’s lives and health. Therefore, enough attention and treatment should be caused in clinical practice. Natural pulmonary surfactant (PS) has achieved positive effects in the treatment of neonatal respiratory distress syndrome (RDS), reducing neonatal mortality, the application of mechanical ventilation, and the occurrence of late complications. To further explore the role of pulmonary surfactants in the treatment of neonatal respiratory distress syndrome, to analyze the best time to use PS to prevent RDS, this paper has selected premature infants with RDS received by the neonatal department of a hospital in a province from March 2019 to October 2020 to compare the efficacy of pulmonary surfactant (PS) in preterm infants with respiratory distress syndrome (RDS). The experiment has found that the average mechanical ventilation time (5.1 d) and oxygen therapy time (7.3 d) in the early group are shorter than the average mechanical ventilation time (6.4 d) and oxygen therapy time (10.6 d) in the late group. It has been demonstrated that early administration of pulmonary surfactant (PS) therapy is of great help in improving respiratory distress syndrome in premature infants.

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Section: Introductionmentioning

confidence: 99%

[Retracted] Profound Effect of Pulmonary Surfactant on the Treatment of Preterm Infants with Respiratory Distress Syndrome

Liu

Deng

2022

Contrast Media & Molecular Imaging

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“…[26][27][28] The first two studies were both small, with eight exposed infants in each, and they had a short follow-up period that only evaluated short-term mortality and an oxygenation index. 26,27 The third study reported that iNO did not improve either the survival or morbidity of children with lung hypoplasia. Our study did not find that iNO was advantageous for pPROM, compared to not using it.…”

Section: Discussionmentioning

confidence: 99%

“…25 This stated that iNO could be used for preterm in- As well as recommending iNO for neonates with PPHN, 25 a number of studies have also suggested that it could be used for infants with respiratory distress syndrome following pPROM, oligohydramnios and lung hypoplasia. [26][27][28] The first two studies were both small, with eight exposed infants in each, and they had a short follow-up period that only evaluated short-term mortality and an oxygenation index. 26,27 The third study reported that iNO did not improve either the survival or morbidity of children with lung hypoplasia.…”

Section: Discussionmentioning

confidence: 99%

Treating very preterm European infants with inhaled nitric oxide increased in‐hospital mortality but did not affect neurodevelopment at 5 years of age

Siljehav,

Gudmundsdottir,

Tjerkaski

et al. 2023

Acta Paediatrica

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AimWe examined the outcomes of using inhaled nitric oxide (iNO) to treat very preterm born (VPT) infants across Europe.MethodsThis was a sub‐study of the Screening to Improve Health in Very Preterm Infants in Europe research. It focused on all infants born between 22 + 0 and 31 + 6 weeks/days of gestation from 2011 to 2012, in 19 regions in 11 European countries. We studied 7268 infants admitted to neonatal care and 5 years later, we followed up the outcomes of 103 who had received iNO treatment. They were compared with 3502 propensity score‐matched controls of the same age who did not receive treatment.ResultsAll countries used iNO and 292/7268 (4.0%) infants received this treatment, ranging from 1.2% in the UK to 10.5% in France. There were also large regional variations within some countries. Infants treated with iNO faced higher in‐hospital mortality than matched controls (odds ratio 2.03, 95% confidence interval 1.33–3.09). The 5‐year follow‐up analysis of 103 survivors showed no increased risk of neurodevelopmental impairment after iNO treatment.ConclusioniNO was used for VPT patients in all 11 countries. In‐hospital mortality was increased in infants treated with iNO, but long‐term neurodevelopmental outcomes were not affected in 103 5‐year‐old survivors.

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“…The rationale that iNO inhalation might benefit a subset of pre-term newborns was based on existing case reports and series. Initially, the investigated pre-term infants presented with PHTN and HRF associated with pre-term premature rupture of membranes (PPROM), as this was proposed to cause PHTN in term and pre-term newborns, possibly by chest compression or decreased distal airway pressure (103,(131)(132)(133)(134). However, the observation that iNO and effective ventilation management dramatically improve oxygenation in newborns with a short period of PPROM is not always consistent with the theory of severe lung hypoplasia.…”

Section: A Personalized Evaluation and Treatment Of Phtn In Pre-term mentioning

confidence: 99%

The Controversy Persists: Is There a Qualification Criterion to Utilize Inhaled Nitric Oxide in Pre-term Newborns?

et al. 2021

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Inhaled nitric oxide (iNO) use in premature newborns remains controversial among clinicians. In 2014, the American Academy of Pediatrics, Committee on Fetus and Newborn released a statement that the available data do not support routine iNO use in pre-term newborns. Despite the absence of significant benefits, 2016 California data showed that clinicians continue to utilize iNO in pre-term infants. With studies as recent as January 2017, the Cochrane review confirmed no major advantages of iNO in pre-term newborns. Still, it recognized that a subset of pre-term infants with pulmonary hypertension (PHTN) had not been separately investigated. Furthermore, recent non-randomized controlled trials have suggested that iNO may benefit specific subgroups of pre-term newborns, especially those with PHTN, prolonged rupture of membranes, and antenatal steroid exposure. Those pre-term infants who showed a clinical response to iNO had increased survival without disability. These findings underscore the need for future studies in pre-term newborns with hypoxemic respiratory failure and PHTN. This review will discuss the rationale for using iNO, controversies regarding the diagnosis of PHTN, and additional novel approaches of iNO treatment in perinatal asphyxia and neonatal resuscitation in the pre-term population < 34 weeks gestation.

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Inhaled Nitric Oxide in Preterm Neonates with Refractory Hypoxemia Associated to Oligohydramnios

Cited by 7 publications

References 0 publications

[Retracted] Profound Effect of Pulmonary Surfactant on the Treatment of Preterm Infants with Respiratory Distress Syndrome

[Retracted] Profound Effect of Pulmonary Surfactant on the Treatment of Preterm Infants with Respiratory Distress Syndrome

Treating very preterm European infants with inhaled nitric oxide increased in‐hospital mortality but did not affect neurodevelopment at 5 years of age

The Controversy Persists: Is There a Qualification Criterion to Utilize Inhaled Nitric Oxide in Pre-term Newborns?

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