First-year outcomes of very low birth weight preterm singleton infants with hypoxemic respiratory failure treated with milrinone and inhaled nitric oxide (iNO) compared to iNO alone: A nationwide retrospective study
Inhaled nitric oxide (iNO) has a beneficial effect on hypoxemic respiratory failure. The increased use of concurrent iNO and milrinone was observed. We aimed to report the trends of iNO use in the past 15 years in Taiwan and compare the first-year outcomes of combining iNO and milrinone to the iNO a...
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| creator | Chang, Ya-Ting Liu, Jia-Rou Chen, Wei-Min Tseng, Chi-Nan See, Lai-Chu |
| description | Inhaled nitric oxide (iNO) has a beneficial effect on hypoxemic respiratory failure. The increased use of concurrent iNO and milrinone was observed. We aimed to report the trends of iNO use in the past 15 years in Taiwan and compare the first-year outcomes of combining iNO and milrinone to the iNO alone in very low birth weight preterm (VLBWP) infants under mechanical ventilation.
This nationwide cohort study enrolled preterm singleton infants with birth weight |
| doi_str_mv | 10.1371/journal.pone.0297137 |
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This nationwide cohort study enrolled preterm singleton infants with birth weight <1500g treated with iNO from 2004 to 2019. Infants were divided into two groups, with a combination of intravenous milrinone (Group 2, n = 166) and without milrinone (Group 1, n = 591). After propensity score matching (PSM), each group's sample size is 124. The primary outcomes were all-cause mortality and the respiratory condition, including ventilator use and duration. The secondary outcomes were preterm morbidities within one year after birth.
After PSM, more infants in Group 2 needed inotropes. The mortality rate was significantly higher in Group 2 than in Group 1 from one month after birth till 1 year of age (55.1% vs. 13.5%) with the adjusted hazard ratio of 4.25 (95%CI = 2.42-7.47, p <0.001). For infants who died before 36 weeks of postmenstrual age (PMA), Group 2 had longer hospital stays compared to Group 1. For infants who survived after 36 weeks PMA, the incidence of moderate and severe bronchopulmonary dysplasia (BPD) was significantly higher in Group 2 than in Group 1. For infants who survived until one year of age, the incidence of pneumonia was significantly higher in Group 2 (28.30%) compared to Group 1 (12.62%) (p = 0.0153).
Combined treatment of iNO and milrinone is increasingly applied in VLBWP infants in Taiwan. This retrospective study did not support the benefits of combining iNO and milrinone on one-year survival and BPD prevention. A future prospective study is warranted.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0297137</identifier><identifier>PMID: 38722851</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Administration, Inhalation ; Age ; Apgar score ; Biology and Life Sciences ; Birth weight ; Care and treatment ; Clinical medicine ; Cohort analysis ; Combined treatment ; Dosage and administration ; Drug therapy, Combination ; Dysplasia ; Female ; Gestational age ; Health aspects ; Humans ; Hypoxia - drug therapy ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Infants ; Infants (Premature) ; Low birth weight ; Lung diseases ; Male ; Maternal & child health ; Mechanical ventilation ; Medicine and Health Sciences ; Methods ; Milrinone ; Milrinone - administration & dosage ; Milrinone - therapeutic use ; Mortality ; National health insurance ; Newborn babies ; Nitric oxide ; Nitric Oxide - administration & dosage ; Nitric Oxide - therapeutic use ; Patient outcomes ; People and Places ; Pneumonia ; Premature babies ; Pulmonary hypertension ; Respiration, Artificial ; Respiratory failure ; Respiratory insufficiency ; Respiratory Insufficiency - drug therapy ; Respiratory Insufficiency - mortality ; Retrospective Studies ; Sepsis ; Survival ; Taiwan - epidemiology ; Treatment Outcome ; Ventilation ; Ventilators</subject><ispartof>PloS one, 2024-05, Vol.19 (5), p.e0297137-e0297137</ispartof><rights>Copyright: © 2024 Chang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Chang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Chang et al 2024 Chang et al</rights><rights>2024 Chang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c608t-f9f3eb4a3e0aa627229b3ee48b0ae485f3c134a03424826e52c192d0f5df54b93</cites><orcidid>0000-0002-1379-8969</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081351/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081351/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38722851$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Namba, Fumihiko</contributor><creatorcontrib>Chang, Ya-Ting</creatorcontrib><creatorcontrib>Liu, Jia-Rou</creatorcontrib><creatorcontrib>Chen, Wei-Min</creatorcontrib><creatorcontrib>Tseng, Chi-Nan</creatorcontrib><creatorcontrib>See, Lai-Chu</creatorcontrib><title>First-year outcomes of very low birth weight preterm singleton infants with hypoxemic respiratory failure treated with milrinone and inhaled nitric oxide (iNO) compared to iNO alone: A nationwide retrospective study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Inhaled nitric oxide (iNO) has a beneficial effect on hypoxemic respiratory failure. The increased use of concurrent iNO and milrinone was observed. We aimed to report the trends of iNO use in the past 15 years in Taiwan and compare the first-year outcomes of combining iNO and milrinone to the iNO alone in very low birth weight preterm (VLBWP) infants under mechanical ventilation.
This nationwide cohort study enrolled preterm singleton infants with birth weight <1500g treated with iNO from 2004 to 2019. Infants were divided into two groups, with a combination of intravenous milrinone (Group 2, n = 166) and without milrinone (Group 1, n = 591). After propensity score matching (PSM), each group's sample size is 124. The primary outcomes were all-cause mortality and the respiratory condition, including ventilator use and duration. The secondary outcomes were preterm morbidities within one year after birth.
After PSM, more infants in Group 2 needed inotropes. The mortality rate was significantly higher in Group 2 than in Group 1 from one month after birth till 1 year of age (55.1% vs. 13.5%) with the adjusted hazard ratio of 4.25 (95%CI = 2.42-7.47, p <0.001). For infants who died before 36 weeks of postmenstrual age (PMA), Group 2 had longer hospital stays compared to Group 1. For infants who survived after 36 weeks PMA, the incidence of moderate and severe bronchopulmonary dysplasia (BPD) was significantly higher in Group 2 than in Group 1. For infants who survived until one year of age, the incidence of pneumonia was significantly higher in Group 2 (28.30%) compared to Group 1 (12.62%) (p = 0.0153).
Combined treatment of iNO and milrinone is increasingly applied in VLBWP infants in Taiwan. This retrospective study did not support the benefits of combining iNO and milrinone on one-year survival and BPD prevention. A future prospective study is warranted.</description><subject>Administration, Inhalation</subject><subject>Age</subject><subject>Apgar score</subject><subject>Biology and Life Sciences</subject><subject>Birth weight</subject><subject>Care and treatment</subject><subject>Clinical medicine</subject><subject>Cohort analysis</subject><subject>Combined treatment</subject><subject>Dosage and administration</subject><subject>Drug therapy, Combination</subject><subject>Dysplasia</subject><subject>Female</subject><subject>Gestational age</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Hypoxia - drug therapy</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Very Low Birth Weight</subject><subject>Infants</subject><subject>Infants (Premature)</subject><subject>Low birth weight</subject><subject>Lung diseases</subject><subject>Male</subject><subject>Maternal & child health</subject><subject>Mechanical ventilation</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Milrinone</subject><subject>Milrinone - administration & dosage</subject><subject>Milrinone - therapeutic use</subject><subject>Mortality</subject><subject>National health insurance</subject><subject>Newborn babies</subject><subject>Nitric oxide</subject><subject>Nitric Oxide - administration & dosage</subject><subject>Nitric Oxide - therapeutic use</subject><subject>Patient outcomes</subject><subject>People and Places</subject><subject>Pneumonia</subject><subject>Premature babies</subject><subject>Pulmonary hypertension</subject><subject>Respiration, Artificial</subject><subject>Respiratory failure</subject><subject>Respiratory insufficiency</subject><subject>Respiratory Insufficiency - drug therapy</subject><subject>Respiratory Insufficiency - mortality</subject><subject>Retrospective Studies</subject><subject>Sepsis</subject><subject>Survival</subject><subject>Taiwan - epidemiology</subject><subject>Treatment 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One</addtitle><date>2024-05-09</date><risdate>2024</risdate><volume>19</volume><issue>5</issue><spage>e0297137</spage><epage>e0297137</epage><pages>e0297137-e0297137</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Inhaled nitric oxide (iNO) has a beneficial effect on hypoxemic respiratory failure. The increased use of concurrent iNO and milrinone was observed. We aimed to report the trends of iNO use in the past 15 years in Taiwan and compare the first-year outcomes of combining iNO and milrinone to the iNO alone in very low birth weight preterm (VLBWP) infants under mechanical ventilation.
This nationwide cohort study enrolled preterm singleton infants with birth weight <1500g treated with iNO from 2004 to 2019. Infants were divided into two groups, with a combination of intravenous milrinone (Group 2, n = 166) and without milrinone (Group 1, n = 591). After propensity score matching (PSM), each group's sample size is 124. The primary outcomes were all-cause mortality and the respiratory condition, including ventilator use and duration. The secondary outcomes were preterm morbidities within one year after birth.
After PSM, more infants in Group 2 needed inotropes. The mortality rate was significantly higher in Group 2 than in Group 1 from one month after birth till 1 year of age (55.1% vs. 13.5%) with the adjusted hazard ratio of 4.25 (95%CI = 2.42-7.47, p <0.001). For infants who died before 36 weeks of postmenstrual age (PMA), Group 2 had longer hospital stays compared to Group 1. For infants who survived after 36 weeks PMA, the incidence of moderate and severe bronchopulmonary dysplasia (BPD) was significantly higher in Group 2 than in Group 1. For infants who survived until one year of age, the incidence of pneumonia was significantly higher in Group 2 (28.30%) compared to Group 1 (12.62%) (p = 0.0153).
Combined treatment of iNO and milrinone is increasingly applied in VLBWP infants in Taiwan. This retrospective study did not support the benefits of combining iNO and milrinone on one-year survival and BPD prevention. A future prospective study is warranted.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>38722851</pmid><doi>10.1371/journal.pone.0297137</doi><tpages>e0297137</tpages><orcidid>https://orcid.org/0000-0002-1379-8969</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
| recordid | cdi_plos_journals_3069285340 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Administration, Inhalation Age Apgar score Biology and Life Sciences Birth weight Care and treatment Clinical medicine Cohort analysis Combined treatment Dosage and administration Drug therapy, Combination Dysplasia Female Gestational age Health aspects Humans Hypoxia - drug therapy Infant Infant, Newborn Infant, Premature Infant, Very Low Birth Weight Infants Infants (Premature) Low birth weight Lung diseases Male Maternal & child health Mechanical ventilation Medicine and Health Sciences Methods Milrinone Milrinone - administration & dosage Milrinone - therapeutic use Mortality National health insurance Newborn babies Nitric oxide Nitric Oxide - administration & dosage Nitric Oxide - therapeutic use Patient outcomes People and Places Pneumonia Premature babies Pulmonary hypertension Respiration, Artificial Respiratory failure Respiratory insufficiency Respiratory Insufficiency - drug therapy Respiratory Insufficiency - mortality Retrospective Studies Sepsis Survival Taiwan - epidemiology Treatment Outcome Ventilation Ventilators |
| title | First-year outcomes of very low birth weight preterm singleton infants with hypoxemic respiratory failure treated with milrinone and inhaled nitric oxide (iNO) compared to iNO alone: A nationwide retrospective study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T10%3A51%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=First-year%20outcomes%20of%20very%20low%20birth%20weight%20preterm%20singleton%20infants%20with%20hypoxemic%20respiratory%20failure%20treated%20with%20milrinone%20and%20inhaled%20nitric%20oxide%20(iNO)%20compared%20to%20iNO%20alone:%20A%20nationwide%20retrospective%20study&rft.jtitle=PloS%20one&rft.au=Chang,%20Ya-Ting&rft.date=2024-05-09&rft.volume=19&rft.issue=5&rft.spage=e0297137&rft.epage=e0297137&rft.pages=e0297137-e0297137&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0297137&rft_dat=%3Cgale_plos_%3EA793256901%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3069285340&rft_id=info:pmid/38722851&rft_galeid=A793256901&rft_doaj_id=oai_doaj_org_article_3688806c73874ac0b38fc0d69c7b391f&rfr_iscdi=true |