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Óxido nítrico inhalado en niños prematuros con enfermedades respiratorias: una revisión sistemática y un metanálisis
Kai Zhou1,2, Weipeng Xu3, Danrui Li3
1Faculty of Medicine, International School, Jinan University, Guangzhou, Guangdong, China.
European journal of medical research
|August 28, 2025
Resumen
El óxido nítrico inhalado (iNO) puede reducir la mortalidad o la displasia broncopulmonar (BPD) en bebés prematuros. Sin embargo, aumenta el riesgo de retinopatía de la prematuridad, y los resultados a largo plazo requieren más estudios.
Área de la Ciencia:
- Medicina neonatal
- Medicina de las vías respiratorias
- Farmacología
Sus antecedentes:
- El óxido nítrico inhalado (iNO) es eficaz en los lactantes a término, pero tiene diferentes riesgos/beneficios en los prematuros.
- Los bebés prematuros tienen una patofisiología única que requiere una investigación específica para iNO.
- Es esencial realizar más investigaciones para comprender el papel de iNO en esta población vulnerable.
Objetivo del estudio:
- Evaluar los efectos a corto y largo plazo de iNO en bebés prematuros.
- Evaluar la eficacia de iNO en el tratamiento de la insuficiencia respiratoria y el síndrome de dificultad respiratoria.
- Determinar el perfil de seguridad de iNO en recién nacidos prematuros.
Principales métodos:
- Se realizó un metanálisis de ensayos controlados aleatorizados y estudios de cohorte.
- Buscado en las principales bases de datos (PubMed, Cochrane, Scopus, Web of Science) hasta mayo de 2025.
- Los resultados primarios incluyeron mortalidad y displasia broncopulmonar (DPB) en varios momentos.
Principales resultados:
- El uso de iNO se relacionó con un riesgo reducido de muerte o BPD (RR 0,94) y BPD en ECA (RR 0,91).
- Se observaron mejoras en el índice de oxigenación y en la PaO2 con concentraciones iniciales de iNO de 5 ppm.
- Se observó un aumento del riesgo de retinopatía de la prematuridad (RR 1,08), sin diferencias significativas en otras enfermedades.
Conclusiones:
- iNO parece reducir el riesgo de muerte o BPD y probablemente reduce el BPD en los bebés prematuros.
- No se encontró ningún impacto significativo en otras morbilidades neonatales o eventos adversos.
- Los datos respiratorios y de desarrollo neurológico a largo plazo son cruciales para una evaluación exhaustiva de iNO en bebés prematuros, especialmente en bebés de peso extremadamente bajo al nacer.
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