Inhaled nitric oxide therapy for pulmonary disorders of the term and preterm infant

Sokol, Gregory M.; Konduri, Girija G.; Meurs, Krisa P. Van

doi:10.1053/j.semperi.2016.05.007

Cited by 33 publications

(24 citation statements)

References 80 publications

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“…Subsequent individual-patient data meta-analysis suggested no specific benefit with prematurity and stated routine use could not be recommended [ 119 ]. Expert review of the topic resulted in consensus opinions from both the NIH and the American Academy of Pediatrics dissuading the routine use of iNO in premature infants [ 120 , 121 ]. Despite these statements, off-label use of iNO in extremely premature infants remains on the rise [ 122 ].…”

Section: Prevention Of Bpdmentioning

confidence: 99%

Bronchopulmonary Dysplasia: Chronic Lung Disease of Infancy and Long-Term Pulmonary Outcomes

Davidson

Berkelhamer

2017

JCM

321

250

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Bronchopulmonary dysplasia (BPD) is a chronic lung disease most commonly seen in premature infants who required mechanical ventilation and oxygen therapy for acute respiratory distress. While advances in neonatal care have resulted in improved survival rates of premature infants, limited progress has been made in reducing rates of BPD. Lack of progress may in part be attributed to the limited therapeutic options available for prevention and treatment of BPD. Several lung-protective strategies have been shown to reduce risks, including use of non-invasive support, as well as early extubation and volume ventilation when intubation is required. These approaches, along with optimal nutrition and medical therapy, decrease risk of BPD; however, impacts on long-term outcomes are poorly defined. Characterization of late outcomes remain a challenge as rapid advances in medical management result in current adult BPD survivors representing outdated neonatal care. While pulmonary disease improves with growth, long-term follow-up studies raise concerns for persistent pulmonary dysfunction; asthma-like symptoms and exercise intolerance in young adults after BPD. Abnormal ventilatory responses and pulmonary hypertension can further complicate disease. These pulmonary morbidities, combined with environmental and infectious exposures, may result in significant long-term pulmonary sequalae and represent a growing burden on health systems. Additional longitudinal studies are needed to determine outcomes beyond the second decade, and define risk factors and optimal treatment for late sequalae of disease.

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Section: Prevention Of Bpdmentioning

confidence: 99%

Bronchopulmonary Dysplasia: Chronic Lung Disease of Infancy and Long-Term Pulmonary Outcomes

Davidson

Berkelhamer

2017

JCM

321

250

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“…However, the use of inhaled nitric oxide to prevent BPD development in preterm infants was not successful. A meta-analysis of the studies of this topic published through January 2016 found no advantages, either when the gas was administered early after birth or when it was administered later [ 106 ], which explains why routine use of nitric oxide is not recommended by experts and scientific societies [ 107 , 108 ]. However, addition of vitamin A to nitric oxide administration can significantly improve final effect of nitric oxide inhalation [ 109 ].…”

Section: Prevention and Treatment Of Bronchopulmonary Dysplasia (Bpd)mentioning

confidence: 99%

Bronchopulmonary dysplasia: clinical aspects and preventive and therapeutic strategies

2018

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BackgroundBronchopulmonary dysplasia (BPD) is the result of a complex process in which several prenatal and/or postnatal factors interfere with lower respiratory tract development, leading to a severe, lifelong disease. In this review, what is presently known regarding BPD pathogenesis, its impact on long-term pulmonary morbidity and mortality and the available preventive and therapeutic strategies are discussed.Main bodyBronchopulmonary dysplasia is associated with persistent lung impairment later in life, significantly impacting health services because subjects with BPD have, in most cases, frequent respiratory diseases and reductions in quality of life and life expectancy. Prematurity per se is associated with an increased risk of long-term lung problems. However, in children with BPD, impairment of pulmonary structures and function is even greater, although the characterization of long-term outcomes of BPD is difficult because the adults presently available to study have received outdated treatment. Prenatal and postnatal preventive measures are extremely important to reduce the risk of BPD.ConclusionBronchopulmonary dysplasia is a respiratory condition that presently occurs in preterm neonates and can lead to chronic respiratory problems. Although knowledge about BPD pathogenesis has significantly increased in recent years, not all of the mechanisms that lead to lung damage are completely understood, which explains why therapeutic approaches that are theoretically effective have been only partly satisfactory or useless and, in some cases, potentially negative. However, prevention of prematurity, systematic use of nonaggressive ventilator measures, avoiding supraphysiologic oxygen exposure and administration of surfactant, caffeine and vitamin A can significantly reduce the risk of BPD development. Cell therapy is the most fascinating new measure to address the lung damage due to BPD. It is desirable that ongoing studies yield positive results to definitively solve a major clinical, social and economic problem.

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“…For example, human and animal studies demonstrate decreased endogenous NO production and increased endothelin production in a variety of neonatal pulmonary hypertensive disorders . Endothelium‐based therapies including inhaled NO have improved outcomes, but these neonates continue to suffer significant morbidity and mortality …”

Section: Introductionmentioning

confidence: 99%

“…[17][18][19][20][21] Endothelium-based therapies including inhaled NO have improved outcomes, but these neonates continue to suffer significant morbidity and mortality. 22,23 Based on the emerging data that children conceived via ART exhibit vascular dysfunction similar to neonates with PVD, and that any IT including ART and NIFT may potentially complicate neonatal respiratory outcomes; the objective of this study was to determine potential differences in outcomes associated with clinical PVD in neonates born with any form of IT and controls. To this end, we conducted a large population-based study of neonatal pulmonary vascular disease (PVD) by using a California birth cohort.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of pulmonary vascular disease in infants conceived with non‐IVF fertility treatment and assisted reproductive technologies at 1 year of age

Fineman

Baer

Chambers

et al. 2019

Pediatric Pulmonology

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Background Assisted reproductive technologies (ARTs) have been associated with the development of endothelial dysfunction. Objective To determine potential differences in outcomes associated with pulmonary vascular disease in infants born to mothers receiving any infertility treatment including ART and non‐IVF fertility treatments (NIFTs). Design/Methods The sample was derived from an administrative database containing detailed information on infant and maternal characteristics for live‐born infants in California (2007‐2012) with gestational age (GA) 22 to 44 weeks. Cases were defined as infants with ICD‐9 code for pulmonary vascular disease (PVD) and records for ART/NIFT. Controls were randomly selected at a 1:4 ratio. The primary outcome was 1‐year mortality. Crude and adjusted odds ratio (OR) with 95% confidence interval (CI) were calculated. Results We identified 159 cases and 636 controls. Mothers that utilized ART/NIFT were older, to be of the Caucasian race, to have pre‐eclampsia, private insurance, and education >12 years (P < .001). Cases compared to controls were more premature, had lower birth weights, and were more often the product of a multiple gestation pregnancy (P < .001). Cases had a higher 1‐year mortality (18.2% vs 9.1%; OR: 2.2; 95% CI: 1.4, 3.6), more severe PVD (86.2% vs 72.3%; OR: 2.4; 95% CI: 1.5, 3.9), and a longer hospital stay (66.7 ± 73.0 vs 32.5 ± 47.2 days; P < .001) than controls. However, when adjusting for GA these differences become statistically insignificant. Conclusion Children born following ART/NIFT with PVD had increased mortality compared to infants with PVD but without ART/NIFT. The primary driver of this relationship is prematurity.

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Inhaled nitric oxide therapy for pulmonary disorders of the term and preterm infant

Cited by 33 publications

References 80 publications

Bronchopulmonary Dysplasia: Chronic Lung Disease of Infancy and Long-Term Pulmonary Outcomes

Bronchopulmonary Dysplasia: Chronic Lung Disease of Infancy and Long-Term Pulmonary Outcomes

Bronchopulmonary dysplasia: clinical aspects and preventive and therapeutic strategies

Outcomes of pulmonary vascular disease in infants conceived with non‐IVF fertility treatment and assisted reproductive technologies at 1 year of age

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