Document Type
Poster
Publication Date
4-13-2023
Abstract
Background: Though inhaled nitric oxide (iNO) is the “gold standard” treatment for persistent pulmonary hypertension in term and near-term infants, its use in the preterm population varies among providers and across institutions. Continuation of this therapy when not indicated can be harmful to the patient and generate unnecessary medical expense. The objective of this study is to evaluate whether tighter regulation of iNO utilization leads to practice changes in both initiation and duration of iNO, specifically in treating the preterm population.
Purpose: Using a unit-wide “iNO Use in Preterm Infants” guideline to promote evidence based management and improve standard of care, we aim to assess clinical outcomes before and after guideline implementation in order to better understand the impact of standardization on the otherwise variably utilized medical intervention of iNO in a preterm infant population.
Methods/Focus: This is a two-part design comprising both retrospective and prospective data collection on infants born ≤ 33 6/7 admitted to UNMH NICU. Retrospective data was collected on 120 patients (IRB No. 21-472) to establish trends in historical iNO use in this population from January 2015 to December 2020. Secondary outcome measures include time on iNO, length of stay, illness severity (CRIB II score), and death before discharge.
An evidence-based, best practice “iNO Use in Preterm Infants” guideline was then developed in collaboration with Pediatric Cardiology and implemented on unit in November 2022 after formal introduction to clinical teams.
Prospective phase currently in-progress (IRB No. 22-294) with inclusion criteria and data collection tools identical to retrospective arm to minimize heterogeneity of outcome measurement before and after guideline implementation. We anticipate completion of enrollment by November 2023.
Recommended Citation
Mullen, Netanya; Samuel Thompson; Jessica Gross; Jon Love; and Jessie Maxwell. "Effect of Stewardship on Inhaled Nitric Oxide use in a Preterm Infant Population." (2023). https://digitalrepository.unm.edu/hsc_2023_pediatric_research/12
Comments
Poster presented at Pediatric Research Forum