Neonates With Respiratory Distress Syndrome: Does Inhaled Nitric Oxide Reduce Mortality?

Neonate, infant, ICU, NICU
Neonate, infant, ICU, NICU
Off-label use of inhaled nitric oxide is not associated with reduced mortality in neonates born at 22 to 29 weeks'gestation with RDS.

HealthDay News — For neonates born at 22 to 29 weeks’ gestation with respiratory distress syndrome (RDS), off-label use of inhaled nitric oxide (iNO) is not associated with reduced mortality, according to a study published in Pediatrics.

William A. Carey, MD, from the Mayo Clinic in Rochester, Minn., and colleagues used the Pediatrix Medical Group Clinical Data Warehouse to identify neonates born at 22 to 29 weeks’ gestation from 2004 to 2014. Singletons who required mechanical ventilation for treatment of RDS were included. Using propensity scores, each patient who received iNO during the first 7 days of life was matched to a patient who had not received iNO at a chronological age before the age of initiation of the case patient. The authors examined the correlation between iNO status and in-hospital mortality.

The researchers identified 993 neonates (2.6%) who received iNO among 37,909 neonates in the study sample. A total of 971 patients were included in each of the 2 matched cohorts. There was no significant correlation between exposure to iNO and mortality (hazard ratio, 1.08; 95% CI, 0.94 to 1.25; P = .29).

“Off-label prescription of iNO is not associated with reduced in-hospital mortality among extremely premature neonates with RDS,” the authors wrote.

Disclosures: One author disclosed financial ties to the pharmaceutical industry.

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Carey WA, Weaver AL, Mara KC, Clark RH. Inhaled nitric oxide in extremely premature neonates with respiratory distress syndrome [published online February 9, 2018]. Pediatrics. doi:10.1542/peds.2017-3108.