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Inhalación de dosis bajas de óxido nítrico en la hipertensión pulmonar persistente del recién nacido
J P Kinsella1, S R Neish, E Shaffer
1Department of Pediatrics, Children's Hospital, Denver, Colorado 80218-1088.
Lancet (London, England)
|October 3, 1992
Resumen
El óxido nítrico (NO) inhalado mejoró rápidamente la oxigenación en recién nacidos con hipertensión pulmonar persistente (HPPP). Las dosis bajas fueron efectivas y sostenidas, evitando la necesidad de oxigenación de la membrana extracorpórea.
Área de la Ciencia:
- Medicina Neonatal La medicina neonatal es una especialidad de la medicina neonatal.
- Cardiología Pediátrica Cardiología pediátrica.
- Medicina de las vías respiratorias.
Sus antecedentes:
- La hipertensión pulmonar persistente del recién nacido (HPPN) es una condición crítica.
- La oxigenación de la membrana extracorpórea (ECMO) es un tratamiento potencial para la NPHPP grave.
- Existen terapias médicas efectivas limitadas para el NPHPP.
Objetivo del estudio:
- Para evaluar la eficacia del óxido nítrico inhalado (NO) en bebés a término con PPHN.
- Para evaluar el impacto del NO inhalado en la oxigenación y la presión arterial sistémica.
- Para determinar la dosis óptima y la duración para la terapia de NO inhalado en PPHN.
Principales métodos:
- Se realizó un estudio en 9 recién nacidos diagnosticados con NPHPP grave.
- El óxido nítrico inhalado (NO) se administró en dosis bajas (10-20 ppm).
- Los niveles de oxigenación y la presión arterial sistémica fueron monitoreados durante el tratamiento.
Principales resultados:
- Los 9 bebés demostraron una rápida mejora en la oxigenación con NO inhalado.
- No se observó ninguna reducción en la presión arterial sistémica.
- 6 bebés tratados durante 24 horas mantuvieron mejoría clínica a 6 ppm NO.
Conclusiones:
- El NO inhalado es un tratamiento seguro y eficaz para la NPHPP grave en recién nacidos.
- Las dosis bajas de NO inhalado pueden mejorar la oxigenación sin efectos hemodinámicos adversos.
- Se observaron beneficios clínicos sostenidos con la terapia continua de NO inhalado.
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