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Outcomes of early inhaled nitric oxide use in premature African American neonates

Journal of Perinatology volume 38, pages 1657–1665 (2018)Cite this article

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Abstract

Objective

Meta-analysis of individual-patient clinical trial data suggests that inhaled nitric oxide (iNO) improves respiratory outcomes in premature African American neonates. We hypothesized that early iNO therapy would be associated with lower mortality and less chronic lung disease (CLD) in extremely premature African American neonates.

Study design

We conducted a retrospective cohort study of propensity score- and race-matched neonates 22–29 weeks gestation who were mechanically ventilated for treatment of respiratory distress and associated pulmonary hypertension (RDS + PPHN). We evaluated the association of iNO within 7 days of life with in-hospital mortality and CLD, using Cox proportional hazards regression and logistic regression, respectively.

Result

Among 178 matched pairs of African American patients, iNO was not associated with lower mortality (HR = 0.94, 95% CI 0.69–1.30) or less CLD (OR = 0.94, 95% CI 0.47–1.87).

Conclusions

Early, off-label iNO use is not associated with improved outcomes in premature African American neonates with RDS + PPHN.

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Author information

Authors and Affiliations

  1. Division of Neonatal Medicine, Mayo Clinic, Rochester, MN, USA

    Christopher A. Collura & William A. Carey

  2. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

    Kristin C. Mara & Amy L. Weaver

  3. Center for Research, Education & Quality, Pediatrix Medical Group, Sunrise, FL, USA

    Reese H. Clark

Authors
  1. Christopher A. Collura
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  2. Kristin C. Mara
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  3. Amy L. Weaver
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  4. Reese H. Clark
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  5. William A. Carey
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Corresponding author

Correspondence to William A. Carey.

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Funding

Data analysis was funded by the Mayo Clinic Children’s Research Center.

Conflict of interest

Reese H. Clark reports support for CME conferences from Mallinckrodt Pharmaceuticals. The remaining authors declare no conflicts of interest.

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Collura, C.A., Mara, K.C., Weaver, A.L. et al. Outcomes of early inhaled nitric oxide use in premature African American neonates. J Perinatol 38, 1657–1665 (2018). https://doi.org/10.1038/s41372-018-0232-6

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