Childhood Pulmonary Function, Exercise Capacity, and Exhaled Nitric Oxide Levels: Outcomes following Neonatal Treatment with Inhaled Nitric Oxide to Prevent Bronchopulmonary Dysplasia

Background and Objectives The use of inhaled nitric oxide (iNO) in +late preterm and term infants with pulmonary hypertension is Food and Drug Administration (FDA) approved and has improved outcomes and survival. iNO use is not FDA approved for preterm infants and previous studies show no mortality benefit. The objectives were 1) to determine the usage of iNO among preterm neonates <35 weeks before and after the 2010 National Institutes of Health consensus statement and 2) to evaluate characteristics and outcomes among preterm neonates who received iNO. Methods This is a population‐based cross‐sectional study. Billing and procedure codes were used to determine iNO usage. Data were queried from the National Inpatient Sample from 2004 to 2016. Neonates were included if gestational age was <35 weeks. The epochs were spilt into 2004–2010 (Epoch 1) and 2011–2016 (Epoch 2). Prevalence of iNO use, mortality, bronchopulmonary dysplasia (BPD), intraventricular hemorrhage, length of stay, mechanical ventilation, and cost of hospitalization. Results There were 4865 preterm neonates <35 weeks who received iNO. There was a significant increase in iNO use during Epoch 2 (p < 0.001). There was significantly higher use in Epoch 2 among neonates small for gestational age (SGA) 2.3% versus 7.2%, congenital heart disease (CHD) 11.1% versus 18.6%, and BPD 35.2% versus 46.8%. Mortality was significantly lower in Epoch 2 19.8% versus 22.7%. Conclusion Usage of iNO was higher after the release of the consensus statement. The increased use of iNO among preterm neonates may be targeted at specific high‐risk populations such as SGA and CHD neonates. There was lower mortality in Epoch 2; however, the cost was doubled.

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Epidemiologic evaluation of inhaled nitric oxide use among neonates with gestational age less than 35 weeks

Peluso

Othman

Karnati

et al. 2021

Pediatric Pulmonology

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Use of impulse oscillometry to assess lung function in prematurely born children and young people: Comparisons with spirometry

Gunawardana

Harris²,

Greenough³

2023

Paediatric Respiratory Reviews

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Pulmonary phenotypes of bronchopulmonary dysplasia in the preterm infant

Gilfillan,

Bhandari

2023

Seminars in Perinatology

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Childhood Pulmonary Function, Exercise Capacity, and Exhaled Nitric Oxide Levels: Outcomes following Neonatal Treatment with Inhaled Nitric Oxide to Prevent Bronchopulmonary Dysplasia

Abstract: Findings indicate no overall differences in pulmonary function or exercise capacity for children who had neonatal iNO treatment compared with placebo.

Cited by 5 publications

References 28 publications

Epidemiologic evaluation of inhaled nitric oxide use among neonates with gestational age less than 35 weeks

Epidemiologic evaluation of inhaled nitric oxide use among neonates with gestational age less than 35 weeks

Use of impulse oscillometry to assess lung function in prematurely born children and young people: Comparisons with spirometry

Pulmonary phenotypes of bronchopulmonary dysplasia in the preterm infant

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