Surfactant Function and Composition in Premature Infants Treated With Inhaled Nitric Oxide

@article{Ballard2007SurfactantFA,
  title={Surfactant Function and Composition in Premature Infants Treated With Inhaled Nitric Oxide},
  author={Philip L Ballard and Jeffrey D. Merrill and William E. Truog and Rodolfo I. Godinez and Marye H. Godinez and Theresa Mcdevitt and Yue-ji Ning and Sergio G. Golombek and Lance A. Parton and Xianqun Luan and Avital Cnaan and Roberta A. Ballard},
  journal={Pediatrics},
  year={2007},
  volume={120},
  pages={346 - 353}
}
OBJECTIVES. We hypothesized that inhaled nitric oxide treatment of premature infants at risk for bronchopulmonary dysplasia would not adversely affect endogenous surfactant function or composition. METHODS. As part of the Nitric Oxide Chronic Lung Disease Trial of inhaled nitric oxide, we examined surfactant in a subpopulation of enrolled infants. Tracheal aspirate fluid was collected at specified intervals from 99 infants with birth weights <1250 g who received inhaled nitric oxide (20 ppm… 
View on AAP
ncbi.nlm.nih.gov
33 Citations
Background Citations
6
Results Citations
1

33 Citations

Citation Type

Citation Type

Randomized Trial of Late Surfactant Treatment in Ventilated Preterm Infants Receiving Inhaled Nitric Oxide.
Late administration of surfactant replacement therapy increases surfactant protein-B content: a randomized pilot study
TLDR
It is concluded that late therapy with surfactant in combination with iNO is safe and transiently increases surfactants SP-B content, possibly leading to improved short- and long-term respiratory outcomes.
Inhaled nitric oxide in premature infants: effect on tracheal aspirate and plasma nitric oxide metabolites
TLDR
iNO causes dose-related increases in NO metabolites in the circulation as well as lung fluid, as evidenced by TA analysis, showing NO delivery to these compartments.
Inflammatory Mediators in Tracheal Aspirates of Preterm Infants Participating in a Randomized Trial of Inhaled Nitric Oxide
TLDR
Treatment with iNO may have played a role in reducing several inflammatory and fibrotic mediators in TA of preterm infants compared to placebo-treated infants, however, survival without BPD was not affected in the main EUNO trial.
Inhaled Nitric Oxide for Preterm Infants
TLDR
The authors' NO CLD study2 is included as 1 of 2 studies testing the effect of inhaled NO (iNO) started beyond the first 3 days of life with the primary outcome of improving survival without bronchopulmonary dysplasia (BPD) measured at 36 weeks' postmenstrual age.
Surfactant Status and Respiratory Outcome in Premature Infants Receiving Late Surfactant Treatment
TLDR
It is concluded that many intubated premature infants are deficient in active surfactant, in part due to increased intra-alveolar metabolism, low SP-B content, and protein inhibition, and that the severity of this deficit is predictive of BPD.
Two-year neurodevelopmental outcomes of ventilated preterm infants treated with inhaled nitric oxide.
Nitric Oxide for preterm infants
TLDR
The neuro-protective effect found in some experimental studies and clinical reports gives a new attractive potential indication of iNO use in this population of preterm infants, but current data of follow-up multicenter randomized controlled trials do not support this effect.
Late Surfactant Administration in Very Preterm Neonates With Prolonged Respiratory Distress and Pulmonary Outcome at 1 Year of Age: A Randomized Clinical Trial.
TLDR
Late surfactant administration did not alter the early course of bronchopulmonary dysplasia in infants with prolonged respiratory distress, however, surfactants-treated infants had reduced respiratory morbidity prior to 1 year of age.
Use of inhaled nitric oxide in preterm infants: a regional survey of practices.
...
1
2
3
4
...

References

SHOWING 1-10 OF 41 REFERENCES
Inflammatory Markers and Mediators in Tracheal Fluid of Premature Infants Treated With Inhaled Nitric Oxide
TLDR
Inhaled nitric oxide, as administered in this study, seemed to be safe and its use was not associated with any increase in airway inflammatory substances.
Surfactant Composition and Function in a Primate Model of Infant Chronic Lung Disease: Effects of Inhaled Nitric Oxide
TLDR
It is concluded that surfactant is often dysfunctional in developing CLD secondary to SP-B deficiency, and NO treatment improves the apparent ability of hydrophobic SP to promote low surface tension, perhaps secondary to less protein inactivation of surfactan, and improves lung volume by a process unrelated to surfactants function.
Inhaled nitric oxide for premature infants with severe respiratory failure.
TLDR
Post hoc analyses suggest that rates of death and bronchopulmonary dysplasia are reduced for infants with a birth weight greater than 1000 g, whereas infants weighing 1000 g or less who are treated with inhaled nitric oxide have higher mortality and increased rates of severe intracranial hemorrhage.
Inhaled nitric oxide in premature infants with the respiratory distress syndrome.
TLDR
The use of inhaled nitric oxide in premature infants with the respiratory distress syndrome decreases the incidence of chronic lung disease and death.
Early inhaled nitric oxide therapy in premature newborns with respiratory failure.
TLDR
Among premature newborns with respiratory failure, low-dose inhaled nitric oxide did not reduce the overall incidence of bronchopulmonary dysplasia, except among infants with a birth weight of at least 1000 g, but it did reduce theOverall risk of brain injury.
Inhaled nitric oxide injures the pulmonary surfactant system of lambs in vivo.
TLDR
Surfactant protein A, isolated from the lungs of lambs that breathed 200 ppm .NO, exhibited decreased ability to aggregate lipids in vitro, consistent with injury to the surfactant apoproteins during inhalation of either 80 or 200ppm .NO for 6 h.
Surfactant replacement in neonates with early chronic lung disease.
TLDR
A single dose of surfactant is effective in reducing oxygen requirements in neonates with early chronic lung disease and surfactant replacement may be useful adjunctive therapy in these neonates.
Inhaled nitric oxide effects on lung structure and function in chronically ventilated preterm lambs.
TLDR
iNO preserves structure and function of airway smooth muscle and enhances alveolar development in preterm lambs with chronic lung disease.
Dysfunction of Pulmonary Surfactant in Chronically Ventilated Premature Infants
TLDR
It is concluded that most premature infants requiring continued respiratory support after 7 d of age experience transient episodes of dysfunctional surfactant that are associated with a deficiency of SP-B and SP-C.
Inhaled nitric oxide affects endogenous surfactant in experimental lung transplantation
TLDR
It is concluded that treatment with inhaled NO after lung transplantation is deleterious for the surfactant system and causes a parallel worsening of arterial oxygenation.
...
1
2
3
4
5
...