Background

Use of nitric oxide in preterm infants is controversial. Even though there is no good evidence, the use of nitric oxide has increased significantly in preterm population over the last decade.

Objectives

To review survival and neurodevelopmental outcome of preterm infants requiring nitric oxide in a tertiary Neonatal Intensive Care Unit.

Methods

Retrospective observational study over 10 year period from Jan 2009 to Dec 2018. Preterm infants needing Nitric oxide for pulmonary hypertension were recruited to the study. All data was collected from Badger (neonatal patient database). Neurodevelopmental outcomes of the survivors were analysed by Bayley’s III scale.

Results

7406 preterm infants <36 weeks were admitted to NICU during study period. 35 needed nitric oxide for pulmonary hypertension. Median gestation was 30+5 (25+2 to 36+1) weeks. Median birth weight was 1635 g (630g to 3380g). 21 (60%) were males and 14 (40%) were females. Echocardiography findings were available for 21 cases (60%) of which 71.4% had confirmed evidence of pulmonary hypertension. Severe respiratory distress syndrome was the leading cause for pulmonary hypertension. Overall survival to discharge was 68.5%.

Neurodevelopmental outcome was available for 15 babies of which 46.6% had a normal neurodevelopment. 26.6% were mildly delayed, 20% were moderately delayed and only 6.6% had severe delay.

Conclusion

The usage of nitric oxide in preterm infants is still very small. Nearly 73% had normal or mild developmental delay. Careful selection of cases is required by echocardiography to improve the outcomes.

Background

Use of nitric oxide in preterm infants is controversial. Even though there is no good evidence, the use of nitric oxide has increased significantly in preterm population over the last decade.

Objectives

To review survival and neurodevelopmental outcome of preterm infants requiring nitric oxide in a tertiary Neonatal Intensive Care Unit.

Methods

Retrospective observational study over 10 year period from Jan 2009 to Dec 2018. Preterm infants needing Nitric oxide for pulmonary hypertension were recruited to the study. All data was collected from Badger (neonatal patient database). Neurodevelopmental outcomes of the survivors were analysed by Bayley’s III scale.

Results

7406 preterm infants <36 weeks were admitted to NICU during study period. 35 needed nitric oxide for pulmonary hypertension. Median gestation was 30+5 (25+2 to 36+1) weeks. Median birth weight was 1635 g (630g to 3380g). 21 (60%) were males and 14 (40%) were females. Echocardiography findings were available for 21 cases (60%) of which 71.4% had confirmed evidence of pulmonary hypertension. Severe respiratory distress syndrome was the leading cause for pulmonary hypertension. Overall survival to discharge was 68.5%.

Neurodevelopmental outcome was available for 15 babies of which 46.6% had a normal neurodevelopment. 26.6% were mildly delayed, 20% were moderately delayed and only 6.6% had severe delay.

Conclusion

The usage of nitric oxide in preterm infants is still very small. Nearly 73% had normal or mild developmental delay. Careful selection of cases is required by echocardiography to improve the outcomes.