SynthesisCMAJ open
Topical nitroglycerin ointment as salvage therapy for peripheral tissue ischemia in newborns: a systematic review.
Open access · diamondAbstract readSystematic Review
In one paragraph
Synthesis in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9citing papers in PubMed
3.3field-weighted citation impact, top 8% of its field
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Who cites it
9 citing papers in PubMed, 13 citations in OpenAlex.
- Increase in methemoglobin fraction due to the use of glyceryl trinitrate patches in preterm infants: a case report and literature review.Frontiers in pediatrics · 2025Article
- Management of iatrogenic acute limb ischaemia in the neonate.BMJ case reports · 2024Article
- Nontopical Nitrates in Flap Perfusion and Delay Phenomenon.Plastic and reconstructive surgery. Global open · 2024Article
- Digital Ischemia in an Extreme Preterm Infant Treated with Nitroglycerin Patch.Case reports in pediatrics · 2024Article
- Methaemoglobinaemia associated with use of glyceryl trinitrate patches in an extremely preterm infant.Journal of paediatrics and child health · 2022Article
- A new approach to skin extravasation injury management during the neonatal period.BMC pediatrics · 2022Article
- Neonatal ischemic limb lesions: From etiology to topical nitroglycerine. A case series analysis.Dermatologic therapy · 2022Article
- [Guidelines for neonatal skin management in the neonatal intensive care unit (2021)].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2021Article
- Topical nitroglycerin in newborns with ischemic injuries: A systematic review.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2021Review
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 3 countries.
Katelyn SushkoSchool of Nursing (Sushko), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of General Pediatrics (Litalien), Department of Pediatrics, and the Rosalind & Morris Goodman Family Pediatric Formulations Centre, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Pharmacy (Ferruccio), Hamilton Health Sciences, Hamilton, Ont.; Rosalind & Morris Goodman Family Pediatric Formulations Centre (Gilpin), Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Mazer-Amirshahi), MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC; Division of Pediatric Hematology/Oncology (Chan), McMaster Children's Hospital, McMaster University, Hamilton, Ont.; Division of Clinical Pharmacology (van den Anker), Department of Pediatrics, Children's National Hospital, Washington, DC; Division of Paediatric Pharmacology and Pharmacometrics (van den Anker), University Children's Hospital, University of Basel, Basel, Switzerland; Division of Neonatology (Lacaze-Masmonteil), Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alta.; Division of Neonatology (Samiee-Zafarghandy), Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ont. sushkokj@mcmaster.ca.
Catherine LitalienSchool of Nursing (Sushko), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of General Pediatrics (Litalien), Department of Pediatrics, and the Rosalind & Morris Goodman Family Pediatric Formulations Centre, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Pharmacy (Ferruccio), Hamilton Health Sciences, Hamilton, Ont.; Rosalind & Morris Goodman Family Pediatric Formulations Centre (Gilpin), Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Mazer-Amirshahi), MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC; Division of Pediatric Hematology/Oncology (Chan), McMaster Children's Hospital, McMaster University, Hamilton, Ont.; Division of Clinical Pharmacology (van den Anker), Department of Pediatrics, Children's National Hospital, Washington, DC; Division of Paediatric Pharmacology and Pharmacometrics (van den Anker), University Children's Hospital, University of Basel, Basel, Switzerland; Division of Neonatology (Lacaze-Masmonteil), Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alta.; Division of Neonatology (Samiee-Zafarghandy), Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ont.
Lauren FerruccioSchool of Nursing (Sushko), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of General Pediatrics (Litalien), Department of Pediatrics, and the Rosalind & Morris Goodman Family Pediatric Formulations Centre, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Pharmacy (Ferruccio), Hamilton Health Sciences, Hamilton, Ont.; Rosalind & Morris Goodman Family Pediatric Formulations Centre (Gilpin), Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Mazer-Amirshahi), MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC; Division of Pediatric Hematology/Oncology (Chan), McMaster Children's Hospital, McMaster University, Hamilton, Ont.; Division of Clinical Pharmacology (van den Anker), Department of Pediatrics, Children's National Hospital, Washington, DC; Division of Paediatric Pharmacology and Pharmacometrics (van den Anker), University Children's Hospital, University of Basel, Basel, Switzerland; Division of Neonatology (Lacaze-Masmonteil), Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alta.; Division of Neonatology (Samiee-Zafarghandy), Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ont.
Andrea GilpinSchool of Nursing (Sushko), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of General Pediatrics (Litalien), Department of Pediatrics, and the Rosalind & Morris Goodman Family Pediatric Formulations Centre, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Pharmacy (Ferruccio), Hamilton Health Sciences, Hamilton, Ont.; Rosalind & Morris Goodman Family Pediatric Formulations Centre (Gilpin), Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Mazer-Amirshahi), MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC; Division of Pediatric Hematology/Oncology (Chan), McMaster Children's Hospital, McMaster University, Hamilton, Ont.; Division of Clinical Pharmacology (van den Anker), Department of Pediatrics, Children's National Hospital, Washington, DC; Division of Paediatric Pharmacology and Pharmacometrics (van den Anker), University Children's Hospital, University of Basel, Basel, Switzerland; Division of Neonatology (Lacaze-Masmonteil), Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alta.; Division of Neonatology (Samiee-Zafarghandy), Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ont.
Maryann Mazer-AmirshahiSchool of Nursing (Sushko), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of General Pediatrics (Litalien), Department of Pediatrics, and the Rosalind & Morris Goodman Family Pediatric Formulations Centre, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Pharmacy (Ferruccio), Hamilton Health Sciences, Hamilton, Ont.; Rosalind & Morris Goodman Family Pediatric Formulations Centre (Gilpin), Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Mazer-Amirshahi), MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC; Division of Pediatric Hematology/Oncology (Chan), McMaster Children's Hospital, McMaster University, Hamilton, Ont.; Division of Clinical Pharmacology (van den Anker), Department of Pediatrics, Children's National Hospital, Washington, DC; Division of Paediatric Pharmacology and Pharmacometrics (van den Anker), University Children's Hospital, University of Basel, Basel, Switzerland; Division of Neonatology (Lacaze-Masmonteil), Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alta.; Division of Neonatology (Samiee-Zafarghandy), Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ont.
Anthony K ChanSchool of Nursing (Sushko), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of General Pediatrics (Litalien), Department of Pediatrics, and the Rosalind & Morris Goodman Family Pediatric Formulations Centre, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Pharmacy (Ferruccio), Hamilton Health Sciences, Hamilton, Ont.; Rosalind & Morris Goodman Family Pediatric Formulations Centre (Gilpin), Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Mazer-Amirshahi), MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC; Division of Pediatric Hematology/Oncology (Chan), McMaster Children's Hospital, McMaster University, Hamilton, Ont.; Division of Clinical Pharmacology (van den Anker), Department of Pediatrics, Children's National Hospital, Washington, DC; Division of Paediatric Pharmacology and Pharmacometrics (van den Anker), University Children's Hospital, University of Basel, Basel, Switzerland; Division of Neonatology (Lacaze-Masmonteil), Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alta.; Division of Neonatology (Samiee-Zafarghandy), Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ont.
John van den AnkerSchool of Nursing (Sushko), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of General Pediatrics (Litalien), Department of Pediatrics, and the Rosalind & Morris Goodman Family Pediatric Formulations Centre, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Pharmacy (Ferruccio), Hamilton Health Sciences, Hamilton, Ont.; Rosalind & Morris Goodman Family Pediatric Formulations Centre (Gilpin), Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Mazer-Amirshahi), MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC; Division of Pediatric Hematology/Oncology (Chan), McMaster Children's Hospital, McMaster University, Hamilton, Ont.; Division of Clinical Pharmacology (van den Anker), Department of Pediatrics, Children's National Hospital, Washington, DC; Division of Paediatric Pharmacology and Pharmacometrics (van den Anker), University Children's Hospital, University of Basel, Basel, Switzerland; Division of Neonatology (Lacaze-Masmonteil), Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alta.; Division of Neonatology (Samiee-Zafarghandy), Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ont.
Thierry Lacaze-MasmonteilSchool of Nursing (Sushko), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of General Pediatrics (Litalien), Department of Pediatrics, and the Rosalind & Morris Goodman Family Pediatric Formulations Centre, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Pharmacy (Ferruccio), Hamilton Health Sciences, Hamilton, Ont.; Rosalind & Morris Goodman Family Pediatric Formulations Centre (Gilpin), Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Mazer-Amirshahi), MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC; Division of Pediatric Hematology/Oncology (Chan), McMaster Children's Hospital, McMaster University, Hamilton, Ont.; Division of Clinical Pharmacology (van den Anker), Department of Pediatrics, Children's National Hospital, Washington, DC; Division of Paediatric Pharmacology and Pharmacometrics (van den Anker), University Children's Hospital, University of Basel, Basel, Switzerland; Division of Neonatology (Lacaze-Masmonteil), Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alta.; Division of Neonatology (Samiee-Zafarghandy), Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ont.
Samira Samiee-ZafarghandySchool of Nursing (Sushko), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Division of General Pediatrics (Litalien), Department of Pediatrics, and the Rosalind & Morris Goodman Family Pediatric Formulations Centre, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Pharmacy (Ferruccio), Hamilton Health Sciences, Hamilton, Ont.; Rosalind & Morris Goodman Family Pediatric Formulations Centre (Gilpin), Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Emergency Medicine (Mazer-Amirshahi), MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC; Division of Pediatric Hematology/Oncology (Chan), McMaster Children's Hospital, McMaster University, Hamilton, Ont.; Division of Clinical Pharmacology (van den Anker), Department of Pediatrics, Children's National Hospital, Washington, DC; Division of Paediatric Pharmacology and Pharmacometrics (van den Anker), University Children's Hospital, University of Basel, Basel, Switzerland; Division of Neonatology (Lacaze-Masmonteil), Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alta.; Division of Neonatology (Samiee-Zafarghandy), Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ont.
Centre Hospitalier Universitaire Sainte-Justine · CAMedStar Georgetown University Hospital · USUniversity of Basel · CHGeorgetown University · USMedStar Washington Hospital Center · USUniversity Children’s Hospital Basel · CH
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTopical nitroglycerin (TNG) ointment has been used for almost 3 decades to treat neonatal peripheral tissue ischemia, but this product is now no longer being produced by its Canadian manufacturer. Our aim was to investigate the efficacy and safety of TNG products in newborns in neonatal intensive care units.
methodsIn this systematic review we searched Embase, CINAHL, MEDLINE, PubMed and Web of Science from inception to April 2020 for studies on the use of TNG products (TNG ointment, TNG spray, glyceryl trinitrate [GTN] patch) for the treatment of neonatal tissue ischemia. We did not apply language or study design limitations. Animal studies and duplicate records were excluded. Two reviewers screened and extracted data. The Tool for Evaluating the Methodological Quality of Case Reports and Case Series was used to assess the risk of bias of individual studies.
resultsWe included 23 articles (20 case reports, 2 case series and 1 retrospective audit) describing the use of TNG ointment, TNG spray or GTN patch in the treatment of 39 tissue ischemia events in 37 newborns. Twenty-three (62.2%), 12 (32.4%), 1 (2.7%) and 1 (2.7%) infants received TNG ointment, GTN patch, both TNG ointment and GTN patch, and TNG spray, respectively. Nineteen (76.0%) and 7 (53.8%) injuries treated with TNG ointment and GTN patch showed complete recovery, respectively. Two (16.7%) infants treated with GTN patch experienced adverse events (i.e., methemoglobinemia) requiring treatment discontinuation.
interpretationTNG ointment presents a safe therapeutic modality for salvage therapy of neonatal tissue ischemia. Engagement of stakeholders is essential to address its recent commercial inaccessibility in Canada.
Indexed as
Salvage TherapyAdministration, CutaneousCatheterization, PeripheralHumansInfant, NewbornIntensive Care Units, NeonatalIschemiaNitroglycerinOintmentsVasodilator AgentsNitroglycerinOintmentsVasodilator Agents
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.