Consider The Evidence: Med/Peds Journal Roundup

July 30, 2006

Yes to NO for preemies?

Filed under: NEJM, pediatrics, pulmonary — medblog @ 8:14 pm

NEJM 6/27 – Two articles address the controversial use of inhaled Nitric Oxide in pre-term infants. Prior studies have shown that nitric-oxide may improve gas exchange and lung development in neonates with respiratory failure. Ballard et al. tested this hypothesis on infants weighing less than 1250g, while Kinsella et al. studied all infants less than 34 weeks of age with respiratory failure.

While Ballard et al. found a significant reduction in the incidence of bronchopulmonary dysplasia, the effect size was not large (43.9 vs 36.8) and the P value made it just under the wire at 0.042.

Kinsella et al. found no difference in mortality for the overall group, but did find a significant improvement in outcomes for the group weighing between 1000-1250g, as well as improvement in several secondary outcomes.

Clearly there has to be some futher research into what patients will benefit most from this expensive therapy before it becomes standard of care. 

NEJM Vol. 355(4)


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