Publication:
Inhaled Nitric Oxide in preterm infants: A systematic review and individual patient data meta-analysis

Issued Date

2010-03-23

Resource Type

Article

ISSN

14712431

DOI

10.1186/1471-2431-10-15

Other identifier(s)

2-s2.0-77952251813

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

BMC Pediatrics. Vol.10, (2010)

Suggested Citation

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 Inhaled Nitric Oxide in preterm infants: A systematic review and individual patient data meta-analysis. BMC Pediatrics. Vol.10, (2010). doi:10.1186/1471-2431-10-15 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/29731

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Title

Inhaled Nitric Oxide in preterm infants: A systematic review and individual patient data meta-analysis

Author(s)

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

Other Contributor(s)

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

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.

Keyword(s)

Medicine

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URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/29731

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Scopus 2006-2010