Retrospective study of preterm infants exposed to inhaled nitric oxide in Kaiser Permanente Southern California: morbidity, mortality and follow-up.

Autor: Bhatt DR; Fontana Medical Center, Kaiser Permanente Southern California, Fontana, CA, USA., Braun D; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA. david.x.braun@kp.org., Dizon RA; Fontana Medical Center, Kaiser Permanente Southern California, Fontana, CA, USA., Shi JM; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA., Weerasinghe S; Fontana Medical Center, Kaiser Permanente Southern California, Fontana, CA, USA., Sabio A; Fontana Medical Center, Kaiser Permanente Southern California, Fontana, CA, USA., Reddy S; Fontana Medical Center, Kaiser Permanente Southern California, Fontana, CA, USA., Lee HC; University of California, San Diego, CA, USA., Ramanathan R; Division of Neonatology, Cedars Sinai Guerin Children's, Cedars Sinai Medical Center, Los Angeles, CA, USA., Lakshminrusimha S; UC Davis Children's Hospital, Sacramento, CA, USA.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2024 Jul 18. Date of Electronic Publication: 2024 Jul 18.
DOI: 10.1038/s41372-024-02051-w
Abstrakt: Objective: Describe characteristics of preterm infants exposed to inhaled nitric oxide (iNO) in Kaiser Permanente Southern California.
Study Design: Case review of preterm infants <34-weeks exposed to iNO during 2010-2020 including respiratory and echocardiographic status, NICU course, and 12-month follow-up.
Results: 270 infants, 2.63% of births<34 weeks, (median, range: 26.1, 22 5/7 -33 6/7 weeks gestation) were exposed to iNO. Median FiO 2 at iNO initiation was 1.0 (IQR 0.94-1.0). Pulmonary hypertension (PH) was not associated with risk-adjusted 2 h oxygenation response or improved survival. Mortality to NICU discharge was 37.4%. Median cost of iNO was $7,695/patient. Discharged survivors experienced frequent rehospitalization (34.9%), use of supplemental oxygen, sildenafil, diuretics, bronchodilators, and steroids. Four infants had persistent PH. Five infants died after NICU discharge.
Conclusions: Preterm infants receiving iNO have high mortality and 1st year morbidity. As currently used, iNO may be an indicator of respiratory disease severity rather than mediator of improved outcomes.
(© 2024. The Author(s).)
Databáze: MEDLINE
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