Inhaled nitric oxide use in preterm infants in California neonatal intensive care units

J Perinatol. 2016 Aug;36(8):635-9. doi: 10.1038/jp.2016.49. Epub 2016 Mar 31.


Objective: To describe inhaled nitric oxide (iNO) exposure in preterm infants and variation in neonatal intensive care unit (NICU) use.

Study design: This was a retrospective cohort study of infants, 22 to 33+6/7 weeks of gestational age (GA), during 2005 to 2013. Analyses were stratified by GA and included population characteristics, iNO use over time and hospital variation.

Results: Of the 65 824 infants, 1718 (2.61%) received iNO. Infants, 22 to 24+6/7 weeks of GA, had the highest incidence of iNO exposure (6.54%). Community NICUs (n=77, median hospital use rate 0.7%) used less iNO than regional NICUs (n=23, median hospital use rate 5.8%). In 22 to 24+6/7 weeks of GA infants, the median rate in regional centers was 10.6% (hospital interquartile range 3.8% to 22.6%).

Conclusion: iNO exposure varied with GA and hospital level, with the most use in extremely premature infants and regional centers. Variation reflects a lack of consensus regarding the appropriate use of iNO for preterm infants.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Administration, Inhalation
  • Bronchodilator Agents / therapeutic use*
  • California
  • Female
  • Gestational Age
  • Humans
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Infant, Premature, Diseases / drug therapy*
  • Infant, Premature, Diseases / mortality
  • Intensive Care Units, Neonatal*
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Nitric Oxide / therapeutic use*
  • Retrospective Studies


  • Bronchodilator Agents
  • Nitric Oxide