Pediatric research
Impact on mortality of inhaled nitric oxide in newborns ≤34 weeks with early hypoxemic respiratory failure: systematic review and meta-analysis
By Alvarado-Socarras JL, Theurel-Martín DE and Manrique-Hernández EF.
Abstract
Introduction
Inhaled nitric oxide (iNO) is approved for hypoxemic respiratory failure (HRF) associated with pulmonary hypertension (PH) in term and near-term neonates; however, its use in preterm infants ≤34 weeks' gestation remains controversial, with limited and inconsistent evidence of survival benefit.
Objective
To evaluate the association between iNO use and mortality in preterm neonates ≤34 weeks' gestation.
Methods
A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Major databases were searched up to October 11, 2025. Observational studies and clinical trials reporting mortality in preterm infants with early HRF treated with iNO were included. A random-effects meta-analysis was performed.