Inhaled nitric oxide in paediatric practice

O. I. Miller, Swee Fong Tang

Research output: Contribution to journalArticle

Abstract

We have learned much in the last two decades about the protean physiological influence of the L-arginine-nitric oxide pathway. We have in turn explored the usefulness of influencing this pathway in manipulating the control of the systemic and pulmonary circulations. Therapeutic use of inhaled nitric oxide for paediatric manifestation of pulmonary hypertensive disease is a very small but exciting chapter in a very much larger story. It is clear that we can influence short-term haemodynamics by using inhaled nitric oxide in therapeutic and probably non-toxic exposure levels. The last rive years has seen the evolution from early experimental delivery and monitoring systems to sophisticated commercially available clinical solutions. Despite only limited licensing, the production of medical grade NO is now mostly governed by good manufacturing practice (GMP) guidelines, with most user centres adopting, or attempting to introduce, uniform practice guidelines. Furthermore, it is clear that although inhaled NO has not become the panacea for the critically ill child in the neonatal and paediatric intensive care unit, it still promises to be a substantial addition to the therapeutic armamentarium. Like other therapies before it, iNO has become a much used, if incompletely tested, therapy. Inhaled NO still has a chance of being rigorously tested in properly constructed clinical trials and it is our hope that further widespread and uncontrolled use will be self-regulated by medical scientists keen to define honestly its appropriate therapeutic role.

Original languageEnglish
Pages (from-to)17-24
Number of pages8
JournalPaediatric and Perinatal Drug Therapy
Volume3
Issue number1
Publication statusPublished - 1999

Fingerprint

Nitric Oxide
Pediatrics
Practice Guidelines
Therapeutics
Pediatric Intensive Care Units
Pulmonary Circulation
Neonatal Intensive Care Units
Therapeutic Uses
Licensure
Critical Illness
Lung Diseases
Arginine
Hemodynamics
Clinical Trials

Keywords

  • Neonate
  • Nitric oxide
  • Pulmonary hypertension

ASJC Scopus subject areas

  • Pharmacology
  • Pediatrics, Perinatology, and Child Health

Cite this

Inhaled nitric oxide in paediatric practice. / Miller, O. I.; Tang, Swee Fong.

In: Paediatric and Perinatal Drug Therapy, Vol. 3, No. 1, 1999, p. 17-24.

Research output: Contribution to journalArticle

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