[Inhaled nitric oxide in pediatrics].
OBJECTIVE
To review the literature on inhaled nitric oxide and to describe its main clinical applications in pediatrics.


METHODS
A 10 year literature review with selection of the most important publications on inhaled nitric oxide, using the Medline and Cochrane Systematic Review databases.


RESULTS
This review was organized as follows: introduction; metabolism and biological effects; clinical applications; dosage, gas administration and weaning; precautions and side-effects. Inhaled nitric oxide use was described in persistent pulmonary hypertension and hypoxia of the newborn, acute respiratory distress syndrome, primary pulmonary hypertension, heart surgery, chronic obstructive pulmonary disease, sickle cell anemia, and bronchospastic disease.


CONCLUSIONS
Inhaled nitric oxide is a therapeutic approach with wide clinical applications in pediatrics. Its use is safe when administered in pediatric intensive care units under strict monitoring. As a pulmonary vasodilator, nitric oxide has beneficial effects on gas exchange and ventilation. Controlled trials, focusing on early gas administration should be performed under many clinical conditions, especially acute respiratory distress syndrome.
Fioretto
José R
JR
Departamento de Pediatria da Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), São Paulo, SP, Brazil. jrf@fmb.unesp.br
D000280:Administration, Inhalation; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008171:Lung Diseases / Q000188:drug therapy; D009569:Nitric Oxide / Q000008:administration & dosage* / Q000009:adverse effects; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects
D014665:Vasodilator Agents; D009569:Nitric Oxide