Inhaled ethyl nitrite gas for persistent pulmonary hypertension of the newborn
Inhaled ethyl nitrite gas for persistent pulmonary hypertension of the newborn
复制标题
DOI：
10.1016/s0140-6736(02)09385-6
复制
发表时间：
2002-07-13
期刊：
影响因子：
168.9
通讯作者：
Stamler, JS
中科院分区：
文献类型：
--
作者：
Moya, MP;Gow, AJ;Stamler, JS
吸入一氧化氮用于缓解肺动脉高压和低氧血症，但会产生有毒的自由基和氮氧化物（NOx），这可能导致反弹性缺氧和额外的肺部和其他疾病。为了解决这些问题，我们评估了吸入O-亚硝基乙醇气体（ENO）作为治疗新生儿持续性肺动脉高压的一种新的替代手段提供一氧化氮生物活性的疗效。我们管理ENO超过4小时的7名新生儿谁需要辅助通气，谁有氧合指数为25或以上。然后在开始吸入一氧化氮治疗前关闭ENO 15分钟。我们的研究结果表明，ENO产生持续改善导管后动脉氧合和全身血流动力学，这是维持在停药观察期。高铁血红蛋白血症的增加是适度的，没有检测到有毒的NOx。因此，ENO可以改善新生儿的氧合和全身血液动力学，似乎可以减少反弹性低氧血症和有毒副产物的产生。
Inhaled nitric oxide is used to alleviate pulmonary hypertension and hypoxaemia, but generates toxic free radicals and oxides of nitrogen (NOx), which can cause rebound-hypoxia and additional pulmonary and other morbidity. To address these problems, we assessed the efficacy of inhaled O-nitrosoethanol gas (ENO) as a novel alternative means of providing nitric oxide bioactivity in the treatment of persistent pulmonary hypertension of newborns. We administered ENO over 4 h to seven neonates who required assisted ventilation, and who had an oxygenation index of 25 or more. ENO was then shut off for 15 min before start of treatment with inhaled nitric oxide. Our results show that ENO produced sustained improvements in postductal arterial oxygenation and systemic haemodynamics, which were maintained during the off-drug observation period. Increases in methaemoglobinaemia were modest and toxic NOx, were not detected. Thus, ENO can improve oxygenation and systemic haemodynamics in neonates, and seems to reduce rebound hypoxaemia and production of toxic byproducts.