Treating very preterm European infants with inhaled nitric oxide increased in‐hospital mortality but did not affect neurodevelopment at 5 years of age

Abstract

AbstractAimWe examined the outcomes of using inhaled nitric oxide (iNO) to treat very preterm born (VPT) infants across Europe.MethodsThis was a sub‐study of the Screening to Improve Health in Very Preterm Infants in Europe research. It focused on all infants born between 22 + 0 and 31 + 6 weeks/days of gestation from 2011 to 2012, in 19 regions in 11 European countries. We studied 7268 infants admitted to neonatal care and 5 years later, we followed up the outcomes of 103 who had received iNO treatment. They were compared with 3502 propensity score‐matched controls of the same age who did not receive treatment.ResultsAll countries used iNO and 292/7268 (4.0%) infants received this treatment, ranging from 1.2% in the UK to 10.5% in France. There were also large regional variations within some countries. Infants treated with iNO faced higher in‐hospital mortality than matched controls (odds ratio 2.03, 95% confidence interval 1.33–3.09). The 5‐year follow‐up analysis of 103 survivors showed no increased risk of neurodevelopmental impairment after iNO treatment.ConclusioniNO was used for VPT patients in all 11 countries. In‐hospital mortality was increased in infants treated with iNO, but long‐term neurodevelopmental outcomes were not affected in 103 5‐year‐old survivors.