Inhaled nitric oxide use in preterm infants in California neonatal intensive care units.

Abstract

ObjectiveTo describe inhaled nitric oxide (iNO) exposure in preterm infants and variation in Neonatal Intensive Care Unit (NICU) use.Study DesignThis was a retrospective cohort study of infants, 22–33+6/7 weeks gestational age (GA), during 2005–2013. Analyses were stratified by GA and included population characteristics, iNO use over time and hospital variation.ResultOf 65 824 infants, 1 718 (2.61%) received iNO. Infants, 22–24+6/7 weeks GA, had the highest incidence of iNO exposure (6.54%). Community NICUs (n = 77, median hospital use rate 0.7%) used less iNO than regional NICUs (n = 23, median hospital use rate 5.8%). In 22–24+6/7 week GA infants the median rate in regional centers was 10.6% (hospital IQR 3.8%–22.6%).ConclusioniNO exposure varied with GA and hospital level, with the most use in extremely premature infants and regional centers. Variation reflects a lack of consensus regarding the appropriate use of iNO for preterm infants.