Xue-rong Huang, Lian Wang, Guo-bao Liang, Sheng-qian Huang, Bao-ying Feng, Lu Zhu, Xu-fang Fan, Mu-lin Yao, Jing Zhang, Meng-jiao Wang, Zhi Zheng, Yao Zhu, Wen-li Duan, Zhan-kui Li, Jian Mao, Li Ma, Fa-lin Xu, Fan Wu, Qiu-fen Wei, Ling Liu, Xin-zhu Lin
Women and Children’s Hospital of Xiamen University School of Medicine. Xiamen Key Laboratory of Perinatal-Neonatal Infection. Guiyang Maternal and Child Healthcare Hospital and Guiyang Children’s Hospital. Maternal and Child Health Hospital of the Guangxi Zhuang Autonomous Region. Third Affiliated Hospital of Guangzhou Medical University. Third Affiliated Hospital of Zhengzhou University. Children’s Hospital of Hebei Province. Shengjing Hospital of China Medical University. Northwest Women’s and Children’s Hospital.
China
Frontiers in Pharmacology
Front Pharmacol 2024; 15:
DOI: 10.3389/fphar.2024.1515030
Abstract
Background: Bronchopulmonary Dysplasia (BPD) is a chronic lung disease affecting preterm infants, with limited prevention and treatment options. Inhaled Nitric Oxide (iNO) is sometimes used to treat Persistent Pulmonary Hypertension of the Newborn (PPHN) and Hypoxemic Respiratory Failure (HRF), and its impact on BPD development remains debated.
Objective: To assess whether iNO-related factors are potential contributors to the development of BPD Grade Ⅱ-Ⅲ in very premature infants (VPI) diagnosed with PPHN or HRF at birth using Propensity Score Matching (PSM).
Methods: We conducted a retrospective cohort study of infants born at 22-32 weeks gestation with PPHN or HRF, treated with iNO for over 3 h. PSM matched groups by gestational age, birth weight, and gender, etc. Multivariate logistic regression evaluated the association between iNO treatment and BPD outcomes to identify influencing factors, while Restricted Cubic Spline (RCS) and mediation analysis examined iNO dose effects and potential mediators like mechanical ventilation time and oxygenation index (OI).
Results: A higher initial iNO dose was significantly associated with a reduced risk of BPD Grade Ⅱ-Ⅲ (adjusted OR = 0.68, 95% CI: 0.52-0.89, p < 0.01). Additionally, administration of iNO within the first 7 days of life was identified as an important influencing factor No significant mediation effects were observed for factors such as mechanical ventilation time and OI.
Conclusion: A higher initial iNO dose within the first 7 days was associated with a reduced risk of BPD Grade Ⅱ-Ⅲ in VPI with PPHN or HRF.
Category
Class III. Pulmonary Hypertension Associated with Lung Disease
Medical Therapy. Efficacy or Lack of Efficacy
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes