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Review
. 2016 Jun 14:21:41.
doi: 10.4103/1735-1995.183990. eCollection 2016.

Inhaled nitric oxide in preterm infants: An updated meta-analysis

Yang Yang  1 , Yun Feng  1 , Xiao-Guang Zhou  1 , Jing-Jing Pan  2 , Xiao-Yu Zhou  1
Affiliations
Review

Inhaled nitric oxide in preterm infants: An updated meta-analysis

Yang Yang et al. J Res Med Sci. .

Abstract

Background: In the past several years, randomized controlled trials (RCTs) have indicated that inhaled nitric oxide (iNO) can potentially lower for both the incidence of bronchopulmonary dysplasia (BPD) and mortality in affected infants. Other research has, however, disagreed with these findings.

Materials and methods: We performed an updated meta analysis of all relevant RCTs to assess the benefits of iNO in preterm infants by searching PubMed, EMBASE, Cochrane databases, Wanfang, VIP, and CNKI databases for English and Chinese references.

Results: Ultimately, 22 RCTs were incorporated. (1) Risk of BPD was significantly lower in preterm infants supplemented with iNO (relative risk [RR] = 0.88; P = 0.0007). There are no differences concerning pulmonary hemorrhage (PH) (RR = 0.94; P = 0.72). (2) Incidences of necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and severe intracranial hemorrhage (ICH) were compared. No significant difference was discovered concerning these risks (RR = 1.21, P = 0.08; RR = 1.01, P = 0.89; and RR = 0.99, P = 0.86). (3) In addition, no significant differences were found between experimental and control groups with respect to morality. (RR = 1.00, P = 0.98).

Conclusion: Our meta analysis has shown a beneficial effect in BPD and morality. In addition, our meta analysis suggests that iNO therapy does not increase the risk of common complications, such as NEC and ROP, and that it may also have no adverse effect on bleeding tendency diseases (severe ICH and PH).

Keywords: Meta-analysis; nitric oxide; preterm.

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Figures

Figure 1
Figure 1
Flow diagram of selection of studies for inclusion in the meta-analysis
Figure 2
Figure 2
Effect of inhaled nitric oxide on bronchopulmonary dysplasia
Figure 3
Figure 3
Effect of inhaled nitric oxide on pulmonary hemorrhage
Figure 4
Figure 4
Effect of inhaled nitric oxide on necrotizing enterocolitis
Figure 5
Figure 5
Effect of inhaled nitric oxide on retinopathy of prematurity
Figure 6
Figure 6
Effect of inhaled nitric oxide on severe intracranial hemorrhage
Figure 7
Figure 7
Effect of inhaled nitric oxide on mortality
Figure 8
Figure 8
Funnel plot to assess publication bias
See this image and copyright information in PMC

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