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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/29731
Title: Inhaled Nitric Oxide in preterm infants: A systematic review and individual patient data meta-analysis
Authors: Lisa M. Askie
Roberta A. Ballard
Gary Cutter
Carlo Dani
Diana Elbourne
David Field
Jean Michel Hascoet
Anna M. Hibbs
John P. Kinsella
Jean Christophe Mercier
Wade Rich
Michael D. Schreiber
Pimol Srisuparp
Nim V. Subhedar
Krisa P. Van Meurs
Merryn Voysey
Keith Barrington
Richard A. Ehrenkranz
Neil Finer
The University of Sydney
UCSF School of Medicine
University of Alabama at Birmingham
Azienda Ospedaliera Careggi
London School of Hygiene & Tropical Medicine
University of Leicester
Maternite Regionale de Nancy
Rainbow Babies and Children's Hosp.
University of Colorado School of Medicine
Serv. Reanim. Pediat.
University of California, San Diego
University of Chicago
Mahidol University
Liverpool Women's Hospital
Stanford University School of Medicine
Centre Hospitalier de L'Universite de Montreal
Yale University School of Medicine
Keywords: Medicine
Issue Date: 23-Mar-2010
Citation: BMC Pediatrics. Vol.10, (2010)
Abstract: Background: Preterm infants requiring assisted ventilation are at significant risk of both pulmonary and cerebral injury. Inhaled Nitric Oxide, an effective therapy for pulmonary hypertension and hypoxic respiratory failure in the full term infant, has also been studied in preterm infants. The most recent Cochrane review of preterm infants includes 11 studies and 3,370 participants. The results show a statistically significant reduction in the combined outcome of death or chronic lung disease (CLD) in two studies with routine use of iNO in intubated preterm infants. However, uncertainty remains as a larger study (Kinsella 2006) showed no significant benefit for iNO for this combined outcome. Also, trials that included very ill infants do not demonstrate significant benefit. One trial of iNO treatment at a later postnatal age reported a decrease in the incidence of CLD. The aim of this individual patient meta-analysis is to confirm or refute these potentially conflicting results and to determine the extent to which patient or treatment characteristics may explain the results and/or may predict benefit from inhaled Nitric Oxide in preterm infants.Methods/Design: The Meta-Analysis of Preterm Patients on inhaled Nitric Oxide (MAPPiNO) Collaboration will perform an individual patient data meta-analysis to answer these important clinical questions. Studies will be included if preterm infants receiving assisted ventilation are randomized to receive inhaled Nitric Oxide or to a control group. The individual patient data provided by the Collaborators will be analyzed on an intention-to-treat basis where possible. Binary outcomes will be analyzed using log-binomial regression models and continuous outcomes will be analyzed using linear fixed effects models. Adjustments for trial differences will be made by including the trial variable in the model specification.Discussion: Thirteen (13) trials, with a total of 3567 infants are eligible for inclusion in the MAPPiNO systematic review. To date 11 trials (n = 3298, 92% of available patients) have agreed to participate. Funding was successfully granted from Ikaria Inc as an unrestricted grant. A collaborative group was formed in 2006 with data collection commencing in 2007. It is anticipated that data analysis will commence in late 2009 with results being publicly available in 2010. © 2010 Askie et al; licensee BioMed Central Ltd.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=77952251813&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/29731
ISSN: 14712431
Appears in Collections:Scopus 2006-2010

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