What type of study is this?

This is a Systematic Review study (also classified as: Meta-Analysis).

September 5, 2025Open Access

Inhaled nitric oxide in preterm infants with respiratory disease: a systematic review and meta-analysis

KZKai ZhouHong Kong Polytechnic University WXWeipeng XuFirst Affiliated Hospital of Jinan University DLD LiLeicester General Hospital

Key Points

iNO reduced the risk of death or bronchopulmonary dysplasia, with a risk ratio of 0.94 from six studies.
In the randomized controlled trial subgroup, iNO also decreased the risk of bronchopulmonary dysplasia with a risk ratio of 0.91.
Observational data indicated increased oxygenation index and partial pressure of oxygen in preterm infants treated with iNO compared to controls.
There is a noted increase in the risk of retinopathy of prematurity in infants receiving iNO, suggesting the need for careful monitoring.

Abstract

Abstract Background Inhaled nitric oxide (iNO) has been shown to be effective in term and near-term infants with specific respiratory diseases. The effects and potential risks of iNO differ substantially in preterm infants with special pathophysiology. Specific study in this population is necessary. Purpose To assess the short-term and long-term effects of iNO in preterm infants with respiratory diseases such as respiratory failure and respiratory distress syndrome. Methods We conducted a meta-analysis of randomized controlled trials and cohort studies comparing iNO with placebo or blank control in preterm infants with respiratory diseases.Databases including PubMed, the Cochrane Library, Scopus, and Web of Science were searched from their inception until May 2025. The primary outcomes were death before discharge, death at 36 weeks’ postmenstrual age (PMA), bronchopulmonary dysplasia (BPD) and death or BPD. Results Thirty-one trials met the inclusion criteria. iNO reduced the incidence of death or BPD (risk ratio RR 0.94, 95% confidence interval CI 0.88 to 0.99, 6 studies, 1954 infants) and BPD in the RCT subgroup (RR 0.91, 95% CI 0.84 to 0.99, 8 studies, 2196 infants).Increases of oxygenation index (Standardized mean difference (SMD) − 0.62, 95% CI − 0.81 to − 0.43, 2 studies, 441 infants) and Partial pressure of oxygen (PaO 2 ) (SMD 0.68, 95% CI 0.49 to 0.87, 2 studies, 441 infants) of preterm infants at 5 ppm initial concentration were observed in the iNO group. The iNO group demonstrated a higher risk of retinopathy of prematurity (RR 1.08, 95% CI 1.01 to 1.16, 17 studies, 7220 infants). No significant differences were observed in other neonatal morbidities or adverse events. Conclusions iNO was associated with a reduced risk of death or BPD and a probably reduction of BPD. There was no effect on other morbidities or adverse events. Data on long-term respiratory and neurodevelopment outcomes are critically needed to further evaluate NO's efficacy in preterm infants, particularly Extremely low birth weight infants.

AI से पूछें

Bookmark

View Full Paper

Cite This Study

Zhou et al. (Fri,) studied this question.

synapsesocial.com/papers/68bb421a2b87ece8dc95867c https://doi.org/https://doi.org/10.1186/s40001-025-03008-1

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

AI से पूछें

Bookmark

View Full Paper