Inhaled Nitric Oxide in Preterm Infants: An Individual-Patient Data Meta-analysis of Randomized Trials
Identifieur interne : 006992 ( Main/Exploration ); précédent : 006991; suivant : 006993Inhaled Nitric Oxide in Preterm Infants: An Individual-Patient Data Meta-analysis of Randomized Trials
Auteurs : Lisa M. Askie [Australie] ; Roberta A. Ballard [États-Unis] ; Gary R. Cutter [États-Unis] ; Carlo Dani [Italie] ; Diana Elbourne [Royaume-Uni] ; David Field [Royaume-Uni] ; Jean-Michel Hascoet [France] ; Anna Maria Hibbs [États-Unis] ; John P. Kinsella [États-Unis] ; Jean-Christophe Mercier [France] ; Wade Rich [États-Unis] ; Michael D. Schreiber [États-Unis] ; Pimol Srisuparp Wongsiridej [Thaïlande] ; Nim V. Subhedar [Royaume-Uni] ; Krisa P. Van Meurs [États-Unis] ; Merryn Voysey [Australie] ; Keith Barrington [Canada] ; Richard A. Ehrenkranz [États-Unis] ; Neil N. Finer [États-Unis]Source :
- Pediatrics : (Evanston) [ 0031-4005 ] ; 2011.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Maladie chronique, Pédiatrie.
English descriptors
- KwdEn :
Abstract
BACKGROUND: Inhaled nitric oxide (iNO) is an effective therapy for pulmonary hypertension and hypoxic respiratory failure in term infants. Fourteen randomized controlled trials (n = 3430 infants) have been conducted on preterm infants at risk for chronic lung disease (CLD). The study results seem contradictory. DESIGN/METHODS: Individual-patient data meta-analysis included randomized controlled trials of preterm infants (<37 weeks' gestation). Outcomes were adjusted for trial differences and correlation between siblings. RESULTS: Data from 3298 infants in 12 trials (96%) were analyzed. There was no statistically significant effect of iNO on death or CLD (59% vs 61%: relative risk [RR]: 0.96 [95% confidence interval (CI): 0.92-1.01]; P = .11) or severe neurologic events on imaging (25% vs 23%: RR: 1.12 [95% CI: 0.98-1.28]; P = .09). There were no statistically significant differences in iNO effect according to any of the patient-level characteristics tested. In trials that used a starting iNO dose of >5 vs ≤5 ppm there was evidence of improved outcome (interaction P = .02); however, these differences were not observed at other levels of exposure to iNO. This result was driven primarily by 1 trial, which also differed according to overall dose, duration, timing, and indication for treatment ; a significant reduction in death or CLD (RR: 0.85 [95% CI: 0.74- 0.98]) was found. CONCLUSIONS: Routine use of iNO for treatment of respiratory failure in preterm infants cannot be recommended. The use of a higher starting dose might be associated with improved outcome, but because there were differences in the designs of these trials, it requires further examination.
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Affiliations:
- Australie, Canada, France, Italie, Royaume-Uni, Thaïlande, États-Unis
- Alabama, Angleterre, Californie, Colorado, Connecticut, Grand Est, Grand Londres, Illinois, Lorraine (région), Nouvelle-Galles du Sud, Ohio, Québec, Île-de-France
- Londres, Montréal, Nancy, Paris, Sydney
- Université de Sydney
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Le document en format XML
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Schreiber</name><affiliation wicri:level="2"><inist:fA14 i1="12"><s1>Department of Pediatrics, University of Chicago</s1><s2>Chicago, Illinois</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Wongsiridej, Pimol Srisuparp" sort="Wongsiridej, Pimol Srisuparp" uniqKey="Wongsiridej P" first="Pimol Srisuparp" last="Wongsiridej">Pimol Srisuparp Wongsiridej</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Division of Neonatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University</s1><s2>Bangkok</s2><s3>THA</s3><sZ>13 aut.</sZ></inist:fA14><country>Thaïlande</country><wicri:noRegion>Bangkok</wicri:noRegion></affiliation></author><author><name sortKey="Subhedar, Nim V" sort="Subhedar, Nim V" uniqKey="Subhedar N" first="Nim V." last="Subhedar">Nim V. Subhedar</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Neonatal Unit, Liverpool Women's Hospital</s1><s2>Liverpool</s2><s3>GBR</s3><sZ>14 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Liverpool</wicri:noRegion></affiliation></author><author><name sortKey="Van Meurs, Krisa P" sort="Van Meurs, Krisa P" uniqKey="Van Meurs K" first="Krisa P." last="Van Meurs">Krisa P. 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Ehrenkranz</name><affiliation wicri:level="2"><inist:fA14 i1="17"><s1>Department of Pediatrics, Yale University School of Medicine</s1><s2>New Haven, Connecticut</s2><s3>USA</s3><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Finer, Neil N" sort="Finer, Neil N" uniqKey="Finer N" first="Neil N." last="Finer">Neil N. Finer</name><affiliation wicri:level="2"><inist:fA14 i1="11"><s1>Division of Neonatology, University of California</s1><s2>San Diego, California</s2><s3>USA</s3><sZ>11 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">11-0444160</idno><date when="2011">2011</date><idno type="stanalyst">PASCAL 11-0444160 INIST</idno><idno type="RBID">Pascal:11-0444160</idno><idno type="wicri:Area/PascalFrancis/Corpus">001919</idno><idno type="wicri:Area/PascalFrancis/Curation">004637</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">001975</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">001975</idno><idno type="wicri:doubleKey">0031-4005:2011:Askie L:inhaled:nitric:oxide</idno><idno type="wicri:Area/Main/Merge">006E26</idno><idno type="wicri:source">PMC</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3387905</idno><idno type="RBID">PMC:3387905</idno><idno type="wicri:Area/Pmc/Corpus">002E97</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002E97</idno><idno type="wicri:Area/Pmc/Curation">002D46</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002D46</idno><idno type="wicri:Area/Pmc/Checkpoint">002268</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002268</idno><idno type="wicri:Area/Ncbi/Merge">000B71</idno><idno type="wicri:Area/Ncbi/Curation">000B71</idno><idno type="wicri:Area/Ncbi/Checkpoint">000B71</idno><idno type="wicri:doubleKey">0031-4005:2011:Askie L:inhaled:nitric:oxide</idno><idno type="wicri:Area/Main/Merge">006466</idno><idno type="wicri:Area/Main/Curation">006992</idno><idno type="wicri:Area/Main/Exploration">006992</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Inhaled Nitric Oxide in Preterm Infants: An Individual-Patient Data Meta-analysis of Randomized Trials</title><author><name sortKey="Askie, Lisa M" sort="Askie, Lisa M" uniqKey="Askie L" first="Lisa M." last="Askie">Lisa M. Askie</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>National Health and Medical Research Council Clinical Trials Centre, University of Sydney</s1><s2>Sydney</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Ballard, Roberta A" sort="Ballard, Roberta A" uniqKey="Ballard R" first="Roberta A." last="Ballard">Roberta A. Ballard</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Pediatrics, University of California at San Francisco, School of Medicine</s1><s2>San Francisco, California</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Cutter, Gary R" sort="Cutter, Gary R" uniqKey="Cutter G" first="Gary R." last="Cutter">Gary R. Cutter</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>School of Public Health, University of Alabama at Birmingham</s1><s2>Birmingham, Alabama</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Alabama</region></placeName></affiliation></author><author><name sortKey="Dani, Carlo" sort="Dani, Carlo" uniqKey="Dani C" first="Carlo" last="Dani">Carlo Dani</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Section of Neonatology, Department of Surgical and Medical Critical Care, Careggi University Hospital of Florence</s1><s2>Florence</s2><s3>ITA</s3><sZ>4 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Florence</wicri:noRegion></affiliation></author><author><name sortKey="Elbourne, Diana" sort="Elbourne, Diana" uniqKey="Elbourne D" first="Diana" last="Elbourne">Diana Elbourne</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Department of Medical Statistics, London School of Hygiene and Tropical Medicine</s1><s2>London</s2><s3>GBR</s3><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Field, David" sort="Field, David" uniqKey="Field D" first="David" last="Field">David Field</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Health Science, University of Leicester</s1><s2>Leicester</s2><s3>GBR</s3><sZ>6 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Leicester</wicri:noRegion></affiliation></author><author><name sortKey="Hascoet, Jean Michel" sort="Hascoet, Jean Michel" uniqKey="Hascoet J" first="Jean-Michel" last="Hascoet">Jean-Michel Hascoet</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Neonatology, Maternite Regionale Universitaire</s1><s2>Nancy</s2><s3>FRA</s3><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Grand Est</region><region type="old region">Lorraine (région)</region><settlement type="city">Nancy</settlement></placeName></affiliation></author><author><name sortKey="Hibbs, Anna Maria" sort="Hibbs, Anna Maria" uniqKey="Hibbs A" first="Anna Maria" last="Hibbs">Anna Maria Hibbs</name><affiliation wicri:level="2"><inist:fA14 i1="08"><s1>Department of Pediatrics, Case Western Reserve University and Rainbow Babies & Children's Hospital</s1><s2>Cleveland, Ohio</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Kinsella, John P" sort="Kinsella, John P" uniqKey="Kinsella J" first="John P." last="Kinsella">John P. Kinsella</name><affiliation wicri:level="2"><inist:fA14 i1="09"><s1>Department of Pediatrics, University of Colorado School of Medicine</s1><s2>Denver, Colorado</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Colorado</region></placeName></affiliation></author><author><name sortKey="Mercier, Jean Christophe" sort="Mercier, Jean Christophe" uniqKey="Mercier J" first="Jean-Christophe" last="Mercier">Jean-Christophe Mercier</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Department of Pediatric Emergency Medicine, Hôpital Robert Debré, Université Paris-7 Denis Diderot</s1><s2>Paris</s2><s3>FRA</s3><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Rich, Wade" sort="Rich, Wade" uniqKey="Rich W" first="Wade" last="Rich">Wade Rich</name><affiliation wicri:level="2"><inist:fA14 i1="11"><s1>Division of Neonatology, University of California</s1><s2>San Diego, California</s2><s3>USA</s3><sZ>11 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Schreiber, Michael D" sort="Schreiber, Michael D" uniqKey="Schreiber M" first="Michael D." last="Schreiber">Michael D. Schreiber</name><affiliation wicri:level="2"><inist:fA14 i1="12"><s1>Department of Pediatrics, University of Chicago</s1><s2>Chicago, Illinois</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Wongsiridej, Pimol Srisuparp" sort="Wongsiridej, Pimol Srisuparp" uniqKey="Wongsiridej P" first="Pimol Srisuparp" last="Wongsiridej">Pimol Srisuparp Wongsiridej</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Division of Neonatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University</s1><s2>Bangkok</s2><s3>THA</s3><sZ>13 aut.</sZ></inist:fA14><country>Thaïlande</country><wicri:noRegion>Bangkok</wicri:noRegion></affiliation></author><author><name sortKey="Subhedar, Nim V" sort="Subhedar, Nim V" uniqKey="Subhedar N" first="Nim V." last="Subhedar">Nim V. Subhedar</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Neonatal Unit, Liverpool Women's Hospital</s1><s2>Liverpool</s2><s3>GBR</s3><sZ>14 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Liverpool</wicri:noRegion></affiliation></author><author><name sortKey="Van Meurs, Krisa P" sort="Van Meurs, Krisa P" uniqKey="Van Meurs K" first="Krisa P." last="Van Meurs">Krisa P. Van Meurs</name><affiliation wicri:level="2"><inist:fA14 i1="15"><s1>Divisian of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Salter Packard Children's Hospital</s1><s2>Palo Alto, California</s2><s3>USA</s3><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Voysey, Merryn" sort="Voysey, Merryn" uniqKey="Voysey M" first="Merryn" last="Voysey">Merryn Voysey</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>National Health and Medical Research Council Clinical Trials Centre, University of Sydney</s1><s2>Sydney</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Barrington, Keith" sort="Barrington, Keith" uniqKey="Barrington K" first="Keith" last="Barrington">Keith Barrington</name><affiliation wicri:level="3"><inist:fA14 i1="16"><s1>Division of Neonatology, Centre Hospitalier Universitaire Ste-Justine, Montreal</s1><s2>Quebec</s2><s3>CAN</s3><sZ>17 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation></author><author><name sortKey="Ehrenkranz, Richard A" sort="Ehrenkranz, Richard A" uniqKey="Ehrenkranz R" first="Richard A." last="Ehrenkranz">Richard A. Ehrenkranz</name><affiliation wicri:level="2"><inist:fA14 i1="17"><s1>Department of Pediatrics, Yale University School of Medicine</s1><s2>New Haven, Connecticut</s2><s3>USA</s3><sZ>18 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Finer, Neil N" sort="Finer, Neil N" uniqKey="Finer N" first="Neil N." last="Finer">Neil N. Finer</name><affiliation wicri:level="2"><inist:fA14 i1="11"><s1>Division of Neonatology, University of California</s1><s2>San Diego, California</s2><s3>USA</s3><sZ>11 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Pediatrics : (Evanston)</title><title level="j" type="abbreviated">Pediatrics : (Evanston)</title><idno type="ISSN">0031-4005</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Pediatrics : (Evanston)</title><title level="j" type="abbreviated">Pediatrics : (Evanston)</title><idno type="ISSN">0031-4005</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Chronic</term><term>Chronic disease</term><term>Clinical trial</term><term>Evidence-based medicine</term><term>Infant</term><term>Inhalation</term><term>Lung disease</term><term>Medical data</term><term>Metaanalysis</term><term>Newborn diseases</term><term>Nitric oxide</term><term>Pediatrics</term><term>Premature</term><term>Prematurity</term><term>Randomization</term><term>Respiratory disease</term><term>Review</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie chronique</term><term>Monoxyde d'azote</term><term>Inhalation</term><term>Prématurité</term><term>Nourrisson</term><term>Prématuré</term><term>Pathologie du nouveau né</term><term>Donnée médicale</term><term>Métaanalyse</term><term>Article synthèse</term><term>Médecine factuelle</term><term>Essai clinique</term><term>Randomisation</term><term>Chronique</term><term>Pathologie des poumons</term><term>Pathologie de l'appareil respiratoire</term><term>Pédiatrie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Maladie chronique</term><term>Pédiatrie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">BACKGROUND: Inhaled nitric oxide (iNO) is an effective therapy for pulmonary hypertension and hypoxic respiratory failure in term infants. Fourteen randomized controlled trials (n = 3430 infants) have been conducted on preterm infants at risk for chronic lung disease (CLD). The study results seem contradictory. DESIGN/METHODS: Individual-patient data meta-analysis included randomized controlled trials of preterm infants (<37 weeks' gestation). Outcomes were adjusted for trial differences and correlation between siblings. RESULTS: Data from 3298 infants in 12 trials (96%) were analyzed. There was no statistically significant effect of iNO on death or CLD (59% vs 61%: relative risk [RR]: 0.96 [95% confidence interval (CI): 0.92-1.01]; P = .11) or severe neurologic events on imaging (25% vs 23%: RR: 1.12 [95% CI: 0.98-1.28]; P = .09). There were no statistically significant differences in iNO effect according to any of the patient-level characteristics tested. In trials that used a starting iNO dose of >5 vs ≤5 ppm there was evidence of improved outcome (interaction P = .02); however, these differences were not observed at other levels of exposure to iNO. This result was driven primarily by 1 trial, which also differed according to overall dose, duration, timing, and indication for treatment ; a significant reduction in death or CLD (RR: 0.85 [95% CI: 0.74- 0.98]) was found. CONCLUSIONS: Routine use of iNO for treatment of respiratory failure in preterm infants cannot be recommended. The use of a higher starting dose might be associated with improved outcome, but because there were differences in the designs of these trials, it requires further examination.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Canada</li><li>France</li><li>Italie</li><li>Royaume-Uni</li><li>Thaïlande</li><li>États-Unis</li></country><region><li>Alabama</li><li>Angleterre</li><li>Californie</li><li>Colorado</li><li>Connecticut</li><li>Grand Est</li><li>Grand Londres</li><li>Illinois</li><li>Lorraine (région)</li><li>Nouvelle-Galles du Sud</li><li>Ohio</li><li>Québec</li><li>Île-de-France</li></region><settlement><li>Londres</li><li>Montréal</li><li>Nancy</li><li>Paris</li><li>Sydney</li></settlement><orgName><li>Université de Sydney</li></orgName></list><tree><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Askie, Lisa M" sort="Askie, Lisa M" uniqKey="Askie L" first="Lisa M." last="Askie">Lisa M. Askie</name></region><name sortKey="Voysey, Merryn" sort="Voysey, Merryn" uniqKey="Voysey M" first="Merryn" last="Voysey">Merryn Voysey</name></country><country name="États-Unis"><region name="Californie"><name sortKey="Ballard, Roberta A" sort="Ballard, Roberta A" uniqKey="Ballard R" first="Roberta A." last="Ballard">Roberta A. Ballard</name></region><name sortKey="Cutter, Gary R" sort="Cutter, Gary R" uniqKey="Cutter G" first="Gary R." last="Cutter">Gary R. Cutter</name><name sortKey="Ehrenkranz, Richard A" sort="Ehrenkranz, Richard A" uniqKey="Ehrenkranz R" first="Richard A." last="Ehrenkranz">Richard A. Ehrenkranz</name><name sortKey="Finer, Neil N" sort="Finer, Neil N" uniqKey="Finer N" first="Neil N." last="Finer">Neil N. Finer</name><name sortKey="Hibbs, Anna Maria" sort="Hibbs, Anna Maria" uniqKey="Hibbs A" first="Anna Maria" last="Hibbs">Anna Maria Hibbs</name><name sortKey="Kinsella, John P" sort="Kinsella, John P" uniqKey="Kinsella J" first="John P." last="Kinsella">John P. Kinsella</name><name sortKey="Rich, Wade" sort="Rich, Wade" uniqKey="Rich W" first="Wade" last="Rich">Wade Rich</name><name sortKey="Schreiber, Michael D" sort="Schreiber, Michael D" uniqKey="Schreiber M" first="Michael D." last="Schreiber">Michael D. Schreiber</name><name sortKey="Van Meurs, Krisa P" sort="Van Meurs, Krisa P" uniqKey="Van Meurs K" first="Krisa P." last="Van Meurs">Krisa P. Van Meurs</name></country><country name="Italie"><noRegion><name sortKey="Dani, Carlo" sort="Dani, Carlo" uniqKey="Dani C" first="Carlo" last="Dani">Carlo Dani</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Elbourne, Diana" sort="Elbourne, Diana" uniqKey="Elbourne D" first="Diana" last="Elbourne">Diana Elbourne</name></region><name sortKey="Field, David" sort="Field, David" uniqKey="Field D" first="David" last="Field">David Field</name><name sortKey="Subhedar, Nim V" sort="Subhedar, Nim V" uniqKey="Subhedar N" first="Nim V." last="Subhedar">Nim V. Subhedar</name></country><country name="France"><region name="Grand Est"><name sortKey="Hascoet, Jean Michel" sort="Hascoet, Jean Michel" uniqKey="Hascoet J" first="Jean-Michel" last="Hascoet">Jean-Michel Hascoet</name></region><name sortKey="Mercier, Jean Christophe" sort="Mercier, Jean Christophe" uniqKey="Mercier J" first="Jean-Christophe" last="Mercier">Jean-Christophe Mercier</name></country><country name="Thaïlande"><noRegion><name sortKey="Wongsiridej, Pimol Srisuparp" sort="Wongsiridej, Pimol Srisuparp" uniqKey="Wongsiridej P" first="Pimol Srisuparp" last="Wongsiridej">Pimol Srisuparp Wongsiridej</name></noRegion></country><country name="Canada"><region name="Québec"><name sortKey="Barrington, Keith" sort="Barrington, Keith" uniqKey="Barrington K" first="Keith" last="Barrington">Keith Barrington</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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