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Inhaled nitric oxide for the prevention of bronchopulmonary dysplasia

William E Truog1

  • 1University of Missouri-Kansas City School of Medicine, Department of Pediatrics, Section of Neonatal-Perinatal Medicine, Children's Mercy Hospitals and Clinics, Kansas City, Missouri 64108, USA. wtruog@cmh.edu

Expert Opinion on Pharmacotherapy
|July 31, 2007
PubMed

Insights

Inhaled nitric oxide (iNO) therapy shows promise in reducing bronchopulmonary dysplasia (BPD) in preterm infants. Further research is needed to determine optimal use and patient selection for this intervention.

Area of Science:

  • Neonatal medicine
  • Respiratory medicine
  • Pharmacology

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant concern in preterm infants.
  • Inhaled nitric oxide (iNO) is being investigated as a potential therapy for BPD.
  • Previous studies have provided preliminary data on iNO's efficacy.

Purpose of the Study:

  • To review and critique the current scientific literature on inhaled nitric oxide (iNO) for BPD prevention or amelioration in preterm infants.
  • To assess the state of the art and science of iNO therapy in this population.

Main Methods:

  • Systematic review and critique of published information.
  • Analysis of six definitive, placebo-controlled clinical trials (>2100 preterm infants).
  • Consideration of earlier non-definitive studies (>350 preterm infants).

Main Results:

  • Substantial clinical experience supports the utility of iNO in preterm infants.
  • iNO therapy can decrease the incidence and possibly the severity of BPD.
  • Optimal treatment parameters (timing, dose, duration, route) and patient selection remain undetermined.

Conclusions:

  • Inhaled nitric oxide (iNO) is a promising therapy for reducing BPD in preterm infants.
  • Further research is required to optimize iNO treatment strategies.
  • Potential adverse neurological effects must be carefully monitored.

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