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Inhaled nitric oxide in acute bronchiolitis: A systematic review and meta-analysis

Ilari Kuitunen1,2, Marjo Renko1,2

  • 1Department of Pediatrics, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.

Pediatric Pulmonology
|November 21, 2023
PubMed

Insights

Inhaled nitric oxide shows no benefit for infant acute bronchiolitis, potentially increasing treatment harms. Further research is needed to confirm efficacy and safety in pediatric care.

Area of Science:

  • Pediatric Respiratory Medicine
  • Critical Care Medicine
  • Evidence-Based Medicine

Background:

  • Acute bronchiolitis is a common infant respiratory illness with limited effective treatments.
  • Inhaled nitric oxide (iNO) has been explored as a potential therapy for acute bronchiolitis.

Approach:

  • Systematic review and meta-analysis of randomized controlled trials involving infants under 2 years with acute bronchiolitis.
  • Analyzed need for intensive care unit admission, length of hospital stay, and adverse events.
  • Assessed evidence certainty using GRADE methodology.

Key Points:

  • Three studies (166 infants) found a non-significant reduction in hospital stay with iNO (-11.3 h).
  • Overall adverse event rates were similar between groups.
  • Treatment-associated harms were more frequent in the iNO group (OR: 3.86).

Conclusions:

  • Low certainty evidence suggests iNO does not reduce hospital stay in infants with acute bronchiolitis.
  • iNO may be associated with a higher rate of treatment-related harms.
  • Larger, high-quality studies are required to definitively assess iNO's efficacy and safety.
Abstract

Keywords:
acute bronchiolitisasthma and early wheezeevidence-based medicine and outcomes

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