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Updated: Dec 12, 2025
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
A quality improvement project improving the value of iNO utilization in preterm and term infants
Hannah Fischer1, Tamina Singh2, Lori Devlin2
1Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY, USA. hmryan01@louisville.edu.
Objective:
Inhaled NO (iNO) is used in the NICU for management of hypoxemic respiratory failure. The cost of iNO is significant and does not consistently improve outcomes in infants <34 weeks.
Project Design:
Our team used The Model for Improvement to design a quality improvement project to utilize iNO for appropriate indications, ensure response to therapy and initiate timely weaning. The project was carried out at a Level IV NICU and successful interventions spread to a smaller Level III NICU.
Results:
This project demonstrated significant improvement in all measures; total iNO hours per month, average iNO hours per patient, and the percentage of prolonged iNO courses. With an estimated cost of $115/h, the cost per patient for iNO use declined by half from $21,620 to $10,580.
Conclusions:
Our team improved the value of iNO utilization at our institution and spread successful interventions to another NICU in our network.
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