Racing against time: leveraging preclinical models to understand pulmonary susceptibility to perinatal acetaminophen exposures.
Am J Physiol Lung Cell Mol Physiol
; 323(1): L1-L13, 2022 07 01.
Article
in En
| MEDLINE
| ID: mdl-35503238
ABSTRACT
Over the past decade, clinicians have increasingly prescribed acetaminophen (APAP) for patients in the neonatal intensive care unit (NICU). Acetaminophen has been shown to reduce postoperative opiate burden, and may provide similar efficacy for closure of the patent ductus arteriosus (PDA) as nonsteroidal anti-inflammatory drugs (NSAIDs). Despite these potential benefits, APAP exposures have spread to increasingly less mature infants, a highly vulnerable population for whom robust pharmacokinetic and pharmacodynamic data for APAP are lacking. Concerningly, preclinical studies suggest that perinatal APAP exposures may result in unanticipated adverse effects that are unique to the developing lung. In this review, we discuss the clinical observations linking APAP exposures to adverse respiratory outcomes and the preclinical data demonstrating a developmental susceptibility to APAP-induced lung injury. We show how clinical observations linking perinatal APAP exposures to pulmonary injury have been taken to the bench to produce important insights into the potential mechanisms underlying these findings. We argue that the available data support a more cautious approach to APAP use in the NICU until large randomized controlled trials provide appropriate safety and efficacy data.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ductus Arteriosus, Patent
/
Acetaminophen
Type of study:
Clinical_trials
/
Prognostic_studies
Limits:
Female
/
Humans
/
Newborn
/
Pregnancy
Language:
En
Journal:
Am J Physiol Lung Cell Mol Physiol
Journal subject:
BIOLOGIA MOLECULAR
/
FISIOLOGIA
Year:
2022
Document type:
Article
Publication country:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
/
US
/
USA