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Am J Perinatol 2016; 33(07): 715-722
DOI: 10.1055/s-0036-1571329
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Trends and Variations in the Use of Inhaled Nitric Oxide in Preterm Infants in Canadian Neonatal Intensive Care Units

Amuchou S. Soraisham
1   Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
2   Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
,
Andrei Harabor
1   Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
,
Sandesh Shivananda
3   Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
,
Ruben Alvaro
4   Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
,
Xiang Y. Ye
5   Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
,
Shoo K. Lee
5   Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
6   Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
,
Prakesh S. Shah
5   Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
6   Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
,
on behalf of the Canadian Neonatal Network › Author Affiliations
Further Information

Publication History

14 October 2015

08 December 2015

Publication Date:
18 February 2016 (online)

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Abstract

Objective To determine the proportion of infants who receive inhaled nitric oxide (iNO), and to characterize the variations in its use by gestational age (GA) and center in infants <34 weeks' gestation.

Design Retrospective analysis was performed in infants born at <34 weeks' gestation and admitted to neonatal intensive care units participating in the Canadian Neonatal Network between January 2010 and December 2013.

Results Of 19,525 infants, 831 (4.2%) received iNO. A total of 369 infants (44%) received iNO during the first 2 days after birth. The proportion of neonates who received iNO in the 22 to 25, 26 to 29, and 30 to 33 weeks' GA groups was 16.1, 6.0, and 1.3%, respectively. Infants in whom iNO was initiated in the first 2 days of age received it for a shorter duration (median, 3 days; interquartile range [IQR], 2–5) as compared with those who started after 2 days (median, 5 days; IQR, 2–11). The use of iNO varied by center, ranging from 0 to 15.5% (p < 0.001).

Conclusion Out of every 25 infants born at <34 weeks' gestation in Canada received iNO, with the highest rate of use in infants born at lower gestation. Further research to identify reasoning, efficacy, and safety of iNO in preterm infants is warranted.

Keywords

infant - inhaled nitric oxide - neonatal intensive care unit - practice variation - preterm
 

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