The Use of Inhaled Nitric Oxide in a Tertiary Neonatal Intensive Care Unit

Area of Science:

• Neonatal Medicine
• Pediatric Critical Care
• Respiratory Physiology

Background:

• Limited evidence exists for standardized protocols regarding inhaled nitric oxide (iNO) use and weaning in neonates.
• Persistent pulmonary hypertension of the newborn (PPHN) is a critical condition requiring effective treatment strategies.

Purpose of the Study:

• To analyze the application and patterns of iNO therapy in a cohort of neonates with PPHN.
• To evaluate the initiation time and duration of iNO treatment in term and preterm infants.

Main Methods:

• Retrospective chart review of neonates receiving iNO for PPHN at a single tertiary neonatal center in 2014.
• Data collected and entered into the European Inhaled Nitric Oxide Registry.
• Analysis of treatment initiation timing and duration based on gestational age.

Main Results:

• Thirty-two neonates received iNO therapy, with 9 infants born before 32 weeks gestation.
• Median time to iNO initiation was 4-5 hours.
• Median duration of iNO treatment was 74 hours for term infants and 66 hours for preterm infants.

Conclusions:

• Current iNO application in PPHN demonstrates variability in practice.
• Expansion of the European Inhaled Nitric Oxide Registry across Irish neonatal units is recommended.
• Development of national guidelines for iNO use and weaning in neonates with PPHN is warranted.