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Nitric therapy in preterm infants: rationalised approach based on functional neonatal echocardiography
Author(s) -
Cheng Daryl R.,
Peart Stacey,
Tan Kenneth,
Sehgal Arvind
Publication year - 2016
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13238
Subject(s) - medicine , pediatrics , intensive care medicine , cardiology
Aim Use of inhaled nitric oxide ( iNO ) in preterm infants is not supported by current evidence. In 2013, in Australia and New Zealand, 14% infants' ≤25 weeks of gestations were administered iNO . Within the cohort administered iNO , we aimed to identify subgroups where it may be more efficacious and compared characteristics before and after the set‐up of the functional echocardiography ( fE cho) programme. Methods A retrospective audit for the period 2000–2013 involving preterm infants administered iNO in the first four weeks of life was performed. Comparisons were made between the two time epochs: up to 2007 and post‐2007. Results Eighty‐five infants fulfilled the inclusion criteria; 62 (73%) were ≤28 weeks of gestation; 51 (60%) survived. Amongst survivors, gestation and birthweight were higher and oxygenation index ( OI ) was lower. Fourteen (16.5%) infants weighed small for gestation age; survival was lower in this subgroup (6/14, 43%, p = 0.0005). The fE cho programme increased prenitric assessments for a definitive diagnosis and monitoring; iNO was started earlier, at a lower OI with a trend towards reduced usage (hours). Conclusion Characteristics of subgroups (within the cohort of infants ≤34 weeks of gestation) more likely to benefit from iNO therapy were identified. Use of fE cho could rationalise usage.