NIH Consensus Development Conference Statement: Inhaled Nitric-Oxide Therapy for Premature Infants

被引：151

作者：

Cole, F. Sessions ^{[1
,2
]}

Alleyne, Claudia ^{[3
]}

Barks, John D. E. ^{[4
,5
]}

Boyle, Robert J. ^{[6
]}

Carroll, John L. ^{[7
,8
]}

Dokken, Deborah ^{[9
]}

Edwards, William H. ^{[10
,11
]}

Georgieff, Michael ^{[12
]}

Gregory, Katherine ^{[13
,14
]}

Johnston, Michael V. ^{[15
,16
,17
,18
]}

Kramer, Michael ^{[19
,20
,21
]}

Mitchell, Christine ^{[22
,23
]}

Neu, Josef ^{[24
]}

Pursley, DeWayne M. ^{[25
,26
,27
]}

Robinson, Walter M. ^{[28
,29
]}

Rowitch, David H. ^{[30
]}

机构：

[1] St Louis Childrens Hosp, St Louis, MO 63110 USA

[2] Washington Univ, Sch Med, Dept Pediat, Div Newborn Med, St Louis, MO 63110 USA

[3] Kaiser Permanente Anaheim, Ctr Med, Neonatal Intens Care Unit, Anaheim, CO USA

[4] Univ Michigan, Sch Med, Dept Pediat & Communicable Dis, Ann Arbor, MI USA

[5] Univ Michigan Hlth Syst, CS Mott Childrens Hosp, Div Neonatal Perinatal Med, Ann Arbor, MI 48109 USA

[6] Univ Virginia, Med Ctr, Dept Pediat, Ctr Biomed Eth,Div Neonatol, Charlottesville, VA USA

[7] Univ Arkansas Med Sci, Coll Med, Dept Pediat, Little Rock, AR 72205 USA

[8] Arkansas Childrens Hosp, Pediat Pulm Div, Little Rock, AR 72205 USA

[9] Consultant Family Centered Care, Chevy Chase, MD USA

[10] Childrens Hosp Dartmouth, Dept Pediat, Hanover, NH USA

[11] Vermont Oxford Network, Lebanon, NH USA

[12] Univ Minnesota, Sch Med, Ctr Neurobehav Dev, Div Neonatol,Dept Pediat & Child Psychol, Minneapolis, MN 55455 USA

[13] Boston Coll, William F Connell Sch Nursing, Dept Nursing, Chestnut Hill, MA 02167 USA

[14] Brigham & Womens Hosp, Chestnut Hill, MA USA

[15] Johns Hopkins Univ, Sch Med, Kennedy Krieger Inst, Dept Pediat Neurol, Baltimore, MD USA

[16] Johns Hopkins Univ, Sch Med, Dept Neurol, Baltimore, MD USA

[17] Johns Hopkins Univ, Sch Med, Dept Pediat, Baltimore, MD USA

[18] Johns Hopkins Univ, Sch Med, Dept Phys Med & Rehabil, Baltimore, MD USA

[19] Canadian Inst Hlth Res, Inst Human Dev Child & Youth Hlth, Ottawa, ON, Canada

[20] McGill Univ, Montreal Childrens Hosp, Fac Med, Dept Pediat & Epidemiol, Montreal, PQ H3H 1P3, Canada

[21] McGill Univ, Montreal Childrens Hosp, Fac Med, Dept Biostat & Occupat Hlth, Montreal, PQ H3H 1P3, Canada

[22] Harvard Univ, Sch Med, Div Med Eth, Boston, MA USA

[23] Childrens Hosp Boston, Off Eth, Boston, MA USA

[24] Univ Florida, Coll Med, Dept Pediat, Div Neonatol, Gainesville, FL USA

[25] Amer Acad Pediat, Sect Perinatal Pediat, Elk Grove Village, IL USA

[26] Harvard Univ, Sch Med, Dept Pediat, Boston, MA 02115 USA

[27] Beth Israel Deaconess Med Ctr, Dept Neonatol, Boston, MA USA

[28] Educ Dev Ctr Inc, Ctr Appl Eth, Washington, DC USA

[29] Vanderbilt Univ, Sch Med, Ctr Biomed Eth & Soc, Div Pediat Allergy Immunol & Pulm Med,Dept Pediat, Nashville, TN 37212 USA

[30] Univ Calif San Francisco, Howard Hughes Med Inst, Dept Pediat, San Francisco, CA 94143 USA

来源：

PEDIATRICS | 2011年 / 127卷 / 02期

关键词：

premature; inhaled nitric-oxide therapy; bronchopulmonary dysplasia;

D O I：

10.1542/peds.2010-3507

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Premature birth is a major public health problem in the United States and internationally. Infants born at or before 32 weeks' gestation (2% of all births in the United States in 2007) are at extremely high risk for death in the neonatal period or for pulmonary, visual, and neurodevelopmental morbidities with lifelong consequences including bronchopulmonary dysplasia, retinopathy of prematurity, and brain injury. Risks for adverse outcomes increase with decreasing gestational age. The economic costs to care for these infants are also substantial (estimated at $26 billion in 2005 in the United States). It is clear that the need for strategies to improve outcomes for this high-risk population is great, and this need has prompted testing of new therapies with the potential to decrease pulmonary and other complications of prematurity. Inhaled nitric oxide (iNO) emerged as one such therapy. To provide health care professionals, families, and the general public with a responsible assessment of currently available data regarding the benefits and risks of iNO in premature infants, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Heart, Lung, and Blood Institute, and the Office of Medical Applications of Research of the National Institutes of Health convened a consensus-development conference. Findings from a substantial body of experimental work in developing animals and other model systems suggest that nitric oxide may enhance lung growth and reduce lung inflammation independently of its effects on blood vessel resistance. Although this work demonstrates biological plausibility and the results of randomized controlled trials in term and near-term infants were positive, combined evidence from the 14 randomized controlled trials of iNO treatment in premature infants of <= 34 weeks' gestation shows equivocal effects on pulmonary outcomes, survival, and neurodevelopmental outcomes. Pediatrics 2011; 127:363-369

引用

页码：363 / 369

页数：7