title: Inhaled nitric oxide in preterm infants: An updated meta-analysis.
abstract: BACKGROUND
  In the past several years, randomized controlled trials (RCTs) have indicated that inhaled nitric oxide (iNO) can potentially lower for both the incidence of bronchopulmonary dysplasia (BPD) and mortality in affected infants. Other research has, however, disagreed with these findings.
  
  
  METHODS
  We performed an updated meta analysis of all relevant RCTs to assess the benefits of iNO in preterm infants by searching PubMed, EMBASE, Cochrane databases, Wanfang, VIP, and CNKI databases for English and Chinese references.
  
  
  RESULTS
  Ultimately, 22 RCTs were incorporated. (1) Risk of BPD was significantly lower in preterm infants supplemented with iNO (relative risk [RR] = 0.88;P= 0.0007). There are no differences concerning pulmonary hemorrhage (PH) (RR = 0.94;P= 0.72). (2) Incidences of necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and severe intracranial hemorrhage (ICH) were compared. No significant difference was discovered concerning these risks (RR = 1.21,P= 0.08; RR = 1.01,P= 0.89; and RR = 0.99,P= 0.86). (3) In addition, no significant differences were found between experimental and control groups with respect to morality. (RR = 1.00,P= 0.98).
  
  
  CONCLUSIONS
  Our meta analysis has shown a beneficial effect in BPD and morality. In addition, our meta analysis suggests that iNO therapy does not increase the risk of common complications, such as NEC and ROP, and that it may also have no adverse effect on bleeding tendency diseases (severe ICH and PH).
authors.affiliation: Department of Neonates, Nanjing Children's Hospital of Nanjing Medical University, Nanjing 210008, P. R. China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Neonates, Nanjing Children's Hospital of Nanjing Medical University, Nanjing 210008, P. R. China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of Neonates, Nanjing Children's Hospital of Nanjing Medical University, Nanjing 210008, P. R. China.
authors.forename: Xiao-Guang
authors.initials: XG
authors.lastname: Zhou
authors.affiliation: Department of Pediatrics, Jiangsu Provincial Hospital of Nanjing Medical University, Nanjing 210029, P. R. China.
authors.forename: Jing-Jing
authors.initials: JJ
authors.lastname: Pan
authors.affiliation: Department of Neonates, Nanjing Children's Hospital of Nanjing Medical University, Nanjing 210008, P. R. China.
authors.forename: Xiao-Yu
authors.initials: XY
authors.lastname: Zhou
keywords: Meta-analysis; nitric oxide; preterm