Inhaled nitric oxide for respiratory failure in preterm infants.
BACKGROUND
This section is under preparation and will be included in the next issue.


OBJECTIVE
To determine whether, in preterm newborn infants who have hypoxic respiratory failure, treatment with inhaled nitric oxide improves oxygenation and reduces the rates of death, or adverse neurodevelopmental outcome.


METHODS
Electronic and hand searching of pediatric/neonatal literature and personal data files.


METHODS
Randomized and quasi randomized studies in preterm infants with hypoxic respiratory failure. Administration of inhaled nitric oxide. Clinically relevant outcomes, including death, oxygenation, intraventricular haemorrhage.


METHODS
One randomized controlled trial of nitric oxide therapy was found in preterm infants with a high risk of developing bronchopulmonary dysplasia (Subhedar 1997).


RESULTS
No significant effect of inhaled nitric oxide on any outcome variable was found. In particular there was no effect on the primary outcome variable of death or bronchopulmonary dysplasia.


CONCLUSIONS
There is currently no published information to support the use of inhaled nitric oxide in preterm infants. Preterm infants should not be treated with inhaled nitric oxide except in the context of prospective, randomized controlled trials.
Barrington
K J
KJ
Pediatrics, Royal Victoria Hospital, 687 av des Pins O, Montreal, P. Quebec, Canada, H3A 1A1. kbarri@po-box.mcgill.ca
Finer
N N
NN
D000280:Administration, Inhalation; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use*; D012131:Respiratory Insufficiency / Q000628:therapy*; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D014665:Vasodilator Agents; D009569:Nitric Oxide