Use of inhaled nitric oxide (iNO) among pediatric patients has increased since 2005 and, during a 10-year time period, mortality rates dropped modestly as the therapeutic approach was applied to a broader range of health ailments, according to an observational analysis presented Feb. 26, 2018 during the 47th Critical Care Congress.
iNO, a colorless odorless gas, is used to treat hypoxic respiratory failure in infants born full-term and near term and also has become an important therapy for acute respiratory distress syndrome and pulmonary hypertension in newborns.
Jonathan Chan, M.D., a Children's National Health System critical care fellow, analyzed de-identified data from patient visits from January 2005 to December 2015 at 47 children's hospitals around the nation. Dr. Chan included 18,343 patients in the analysis. Among the findings:
"This large observational study indicates that the use of iNO grew from 2005 to 2015," Dr. Chan says. "While hospital stays grew longer during the study period, we saw a decrease in mortality of 0.01 percent per year."
The highest number of admissions with iNO use included:
Dr. Chan notes that because this is a retrospective observational analysis, the study's findings should be interpreted as exploratory.
"Off-label use of iNO continues to increase among pediatric patients. And an increasing proportion of admissions are for specialty areas other than neonatal care," he adds. "Increasing off-label use of iNO is associated with decreased mortality. But it also is associated with an increased length of stay, higher hospital costs and more units of iNO administered."
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47th Critical Care Congress Presentation
Monday, Feb. 26, 2018
"Evaluating 10 years of inhaled nitric oxide use in pediatric patients."
9-10 a.m. (CST)
Jonathan Chan, M.D., Darren Klugman, M.D., and Anita Patel, M.D.