Early treatment with inhaled nitric oxide is not associated with improved survival among extremely preterm neonates with pulmonary hypoplasia, according to a recent study. This cohort study used data from the Pediatrix Medical Group’s Clinical Data Warehouse, a data set containing information from >350 neonatal intensive care units in 35 US states and Puerto Rico. Since inhaled nitric oxide was not randomly prescribed, researchers used 1-to-1 propensity score matching to reduce the imbalance of measured covariates between the 2 treatment groups. The initial, unmatched cohort included singleton neonates who were born between 22 and 29 weeks’ gestation, had a birth weight of ≥400 g, were diagnosed with pulmonary hypoplasia as a cause of their respiratory distress, remained free of major anomalies, and were discharged between January 1, 2000, and December 31, 2014. They found:
- Among 92,635 neonates,767 (0.8%) were identified with pulmonary hypoplasia who met all study inclusion criteria, of whom 185 (0.2%) were exposed to inhaled nitric oxide.
- Among 151 matched pairs of exposed and unexposed neonates, there was not a significant association between inhaled nitric oxide use and mortality.
Ellsworth KR, Ellsworth MA, Weaver A, Mara KC, Clark RH, Carey WA. Association of early inhaled nitric oxide with the survival of preterm neonates with pulmonary hypoplasia. [Published online ahead of print May 7, 2018]. JAMA Pediatrics. doi:10.1001/jamapediatrics.2018.0761.
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