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[Inhaled nitric oxide in pediatrics].

José R Fioretto1

  • 1Departamento de Pediatria da Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), São Paulo, SP, Brazil. jrf@fmb.unesp.br

Jornal De Pediatria
|December 4, 2003
PubMed
Summary

Inhaled nitric oxide (iNO) is a safe and effective pulmonary vasodilator for pediatric patients, improving gas exchange in various respiratory conditions. Further research is recommended for early iNO administration in acute respiratory distress syndrome.

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Area of Science:

  • Pediatric Pulmonology
  • Neonatology
  • Critical Care Medicine

Background:

  • Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator.
  • Its therapeutic potential in pediatric respiratory diseases has been explored over the past decade.

Purpose of the Study:

  • To conduct a comprehensive literature review on inhaled nitric oxide.
  • To delineate its primary clinical applications within pediatric medicine.

Main Methods:

  • A decade-long literature review was performed.
  • Key publications were selected from Medline and Cochrane Systematic Review databases.

Main Results:

  • iNO demonstrated utility in persistent pulmonary hypertension of the newborn, acute respiratory distress syndrome, and pediatric pulmonary hypertension.

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  • Applications extend to heart surgery, chronic obstructive pulmonary disease, sickle cell anemia, and bronchospastic disease.
  • The review covered iNO's metabolism, biological effects, administration, and safety profile.

    • Conclusions:

    • Inhaled nitric oxide represents a valuable therapeutic option in pediatrics, particularly for improving gas exchange and ventilation.
    • Safe administration requires pediatric intensive care unit settings with rigorous monitoring.
    • Controlled trials investigating early iNO administration are warranted, especially for acute respiratory distress syndrome.