一氧化氮吸入疗法临床应用专家共识(2024版)

Expert consensus on clinical application of inhaled nitric oxide therapy(2024 edition)

吸入一氧化氮(iNO)作为一种选择性肺血管扩张剂,已被应用于多种心肺疾病的新生儿、儿童和成人,以达到降低肺动脉压和改善氧合的目的。目前市面上的iNO设备品牌繁杂、性能差异大以及连接和设置各异,同时患者iNO治疗过程中可能发生高铁血红蛋白血症等不良反应,因此iNO疗法在临床应用的安全性和有效性需要得到保证。为规范iNO疗法的临床应用,中华医学会呼吸病学分会呼吸治疗学组与中国医师协会呼吸医师分会呼吸职业发展委员会呼吸治疗师工作组组织相关专家,根据最新的研究进展和临床操作经验制订了iNO疗法临床应用专家共识。本共识包含了针对iNO适应证和禁忌证,iNO相关治疗设备的选择和连接,iNO剂量选择和疗效评估,iNO治疗期间的不良反应和职业防护,iNO应用患者的转运,iNO的撤离,iNO设备的清洁消毒和维护保养,以及iNO应用流程和记录的11条专家共识推荐意见,旨在提高临床操作者对iNO疗法规范化应用的认知和实践能力,从而保证该疗法在临床应用过程中的安全性和有效性。

Inhaled nitric oxide(iNO)is a selective pulmonary vasodilator that has been used in newborns,children,and adults with various cardiopulmonary diseases to reduce pulmonary artery pressure and improve oxygenation.Currently,there are numerous brands of iNO devices on the market with significant differences in performance,as well as variations in connection and setup.Additionally,adverse reactions such as methemoglobinemia may occur during iNO treatment.Therefore,the safety and efficacy of this treatment need to be ensured in clinical practice.To address these concerns and standardize the clinical application of iNO therapy,the Respiratory Care Group of Chinese Thoracic Society and Respiratory Therapist Working Group of Respiratory Career Development Committee,Chinese Association of Chest Physician have organized relevant experts to develop an expert consensus on the clinical application of iNO therapy based on the latest research progress and clinical operational experience.This consensus includes 11 expert consensus recommendations on indications and contraindications of iNO,selection and connection of iNO devices,dose selection and therapeutic effect evaluation of iNO,adverse effects and occupational protection during iNO treatment,transport of patients with iNO,weaning of iNO,cleaning,disinfection and maintenance of iNO devices,and iNO clinical use process and records.The aim is to improve the cognitive and practical ability of clinical practitioners for the standardized application of iNO therapy,so as to ensure the safety and effectiveness of clinical application of iNO therapy.