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Trials of inhaled nitric oxide (NO) to prevent the development of bronchopulmonary dysplasia (BPD) in preterm infants have given varying results. Now a large trial in nine European Union countries (Lancet 2010;376:346–54; see also Comment, ibid: 308–10) has shown no benefit. A total of 800 infants of gestational age at birth 24–28 weeks and birth weight 500 g or greater, and who needed surfactant or continuous positive airway pressure within 24 h of birth, were randomised to inhaled NO (5 parts per million) or placebo (nitrogen) for 7–21 days. The results were similar in the two groups: survival without BPD, 65% (NO) versus 66% (placebo); survival at 36 weeks post menstrual age, 86% versus 90%; development of BPD, 24% versus 27%; survival to 36 weeks postmenstrual age without brain injury, 69% versus 76%. Lancet commentators suggest that the differences in the results of the various trials might be due to differences in the treatment given and in the infants treated, and that inhaled NO may be more effective at higher concentrations and for longer periods, in infants with less severe respiratory distress syndrome, in more mature preterm infants, and in black infants. They call for more trials to address these points.
Hypertrophic cardiomyopathy is caused by mutations in sarcomere protein genes and has a prevalence of about 1 in 500 people. A study by US and Spanish researchers (New England Journal of …