Inhaled nitric oxide use in neonates with congenital diaphragmatic hernia.

[congenital diaphragmatic hernia]

To describe the use of inhaled nitric oxide (INO ) in newborns with congenital diaphragmatic hernia (CDH ).Pediatric Health Information System data were queried for newborns with CDH admitted at <8 days of age at tertiary care US pediatric hospitals between 2003 and 2011 . INO treatment status and timing in relation to CDH repair were determined for each infant . Hospital -specific rates of INO use , extracorporeal membrane oxygenation (ECMO ) use , and mortality were determined .Data were analyzed for 1713 neonates with CDH admitted to 33 hospitals . More than half (57 %) received INO during their inpatient stay , and utilization varied dramatically between hospitals (34 % to 92 %). Neonates treated with INO accumulated >$81 million in pharmacy charges . The proportion of infants receiving INO as well as their duration of therapy increased significantly during the study period . The rate of ECMO utilization and mortality did not change significantly during the study period . Hospital -specific mortality rates did not correlate with INO therapy , ECMO utilization , or case volume .INO use in neonates with CDH is widespread , and has increased at many US tertiary pediatric hospitals without contemporaneous change in ECMO utilization or mortality . The improvement of evidence-based guidelines for the use of INO in newborns with CDH could lead to a reduction in health care costs for these patients .