Standardization of nitric oxide inhalation in extremely preterm infants in Japan
Background In perinatal medicine, inhaled nitric oxide (iNO) has been an important tool for the treatment of full‐term and late‐preterm infants with persistent pulmonary hypertension of the newborn (PPHN) and hypoxemic respiratory failure (HRF). Its use in more premature infants, however, is controv...
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| Veröffentlicht in: | Pediatrics international 2019-02, Vol.61 (2), p.152-157 |
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| creator | Shiraishi, Jun Kusuda, Satoshi Cho, Kazutoshi Nakao, Atsushi Hiroma, Takehiko Sugiura, Hiroshi Suzuki, Satoshi Oshiro, Makoto Yoshimoto, Seiji Watabe, Shinichi |
| description | Background
In perinatal medicine, inhaled nitric oxide (iNO) has been an important tool for the treatment of full‐term and late‐preterm infants with persistent pulmonary hypertension of the newborn (PPHN) and hypoxemic respiratory failure (HRF). Its use in more premature infants, however, is controversial. To evaluate the current clinical practices regarding use of acute iNO in extremely preterm infants, a nationwide survey was conducted in Japan.
Methods
A questionnaire survey was conducted from May to September, 2015. Questionnaires about PPHN and iNO treatment were sent to the doctor in charge of the neonatal care unit in 213 perinatal medical centers (PMC) that possessed iNO equipment in Japan.
Results
A total of 143 of the 213 PMC provided responses (67.1%). A diagnosis of PPHN was made exclusively on echocardiography in all PMC. On definitive PPHN diagnosis, iNO was selected in the majority of the PMC (72%) and started from ≤10 p.p.m. in most PMC (49.7%) for extremely preterm infants. During iNO therapy, cardiac function was checked on echocardiography by a neonatologist every ≤8 h. iNO weaning was started when differential peripheral oxygen saturation (SpO2) disappeared, or when SpO2 reached 100% and so on. After iNO concentration reached 5 p.p.m., it was decreased gradually and carefully in five steps, taking 12–24 h to go from 5 to 0 p.p.m.
Conclusions
Inhaled nitric oxide was predominantly used in extremely preterm infants as early rescue therapy for PPHN based on echocardiography performed by a neonatologist. |
| doi_str_mv | 10.1111/ped.13746 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2155914788</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2185992175</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3776-eca738adad4ae69ce9d01b0bd93dde94aaa28e74eb8f141b3d5d1ac943619ef3</originalsourceid><addsrcrecordid>eNp10MtKxDAUBuAgipfRhS8gBTe6qCZN2iRLGccbgoIu3JXT5hQjbVqTDjo-vdHqRjCbhHM-fsJPyD6jJyye0wHNCeNSFGtkmwmRpRmlT-vxzTOVKlrILbITwgulVEklNskWp3nGi4Jtk_uHEZwBb-wHjLZ3Sd8kzo7e1kn_bg0m1j1DO62sS_B99Nhhu0oGjyP6Lg4bcGP4Wt7AAG6XbDTQBtz7uWfk8WLxOL9Kb-8ur-dnt2nNpSxSrEFyBQaMACx0jdpQVtHKaG4MagEAmUIpsFINE6ziJjcMai14wTQ2fEaOptjB969LDGPZ2VBj24LDfhnKjOW5ZkIqFenhH_rSL72Ln4tK5VpnTOZRHU-q9n0IHpty8LYDvyoZLb9aLmPL5XfL0R78JC6rLk5_5W-tEZxO4M22uPo_qbxfnE-Rn2u4h2g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2185992175</pqid></control><display><type>article</type><title>Standardization of nitric oxide inhalation in extremely preterm infants in Japan</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Shiraishi, Jun ; Kusuda, Satoshi ; Cho, Kazutoshi ; Nakao, Atsushi ; Hiroma, Takehiko ; Sugiura, Hiroshi ; Suzuki, Satoshi ; Oshiro, Makoto ; Yoshimoto, Seiji ; Watabe, Shinichi</creator><creatorcontrib>Shiraishi, Jun ; Kusuda, Satoshi ; Cho, Kazutoshi ; Nakao, Atsushi ; Hiroma, Takehiko ; Sugiura, Hiroshi ; Suzuki, Satoshi ; Oshiro, Makoto ; Yoshimoto, Seiji ; Watabe, Shinichi</creatorcontrib><description>Background
In perinatal medicine, inhaled nitric oxide (iNO) has been an important tool for the treatment of full‐term and late‐preterm infants with persistent pulmonary hypertension of the newborn (PPHN) and hypoxemic respiratory failure (HRF). Its use in more premature infants, however, is controversial. To evaluate the current clinical practices regarding use of acute iNO in extremely preterm infants, a nationwide survey was conducted in Japan.
Methods
A questionnaire survey was conducted from May to September, 2015. Questionnaires about PPHN and iNO treatment were sent to the doctor in charge of the neonatal care unit in 213 perinatal medical centers (PMC) that possessed iNO equipment in Japan.
Results
A total of 143 of the 213 PMC provided responses (67.1%). A diagnosis of PPHN was made exclusively on echocardiography in all PMC. On definitive PPHN diagnosis, iNO was selected in the majority of the PMC (72%) and started from ≤10 p.p.m. in most PMC (49.7%) for extremely preterm infants. During iNO therapy, cardiac function was checked on echocardiography by a neonatologist every ≤8 h. iNO weaning was started when differential peripheral oxygen saturation (SpO2) disappeared, or when SpO2 reached 100% and so on. After iNO concentration reached 5 p.p.m., it was decreased gradually and carefully in five steps, taking 12–24 h to go from 5 to 0 p.p.m.
Conclusions
Inhaled nitric oxide was predominantly used in extremely preterm infants as early rescue therapy for PPHN based on echocardiography performed by a neonatologist.</description><identifier>ISSN: 1328-8067</identifier><identifier>EISSN: 1442-200X</identifier><identifier>DOI: 10.1111/ped.13746</identifier><identifier>PMID: 30523661</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Diagnosis ; Echocardiography ; Health care facilities ; Infants ; Inhalation ; low birthweight ; Neonates ; Newborn babies ; Nitric oxide ; Oxygen content ; Pediatrics ; persistent pulmonary hypertension of the newborn ; Premature babies ; Respiration ; respiratory distress syndrome ; Respiratory failure ; Respiratory therapy ; Standardization ; Weaning</subject><ispartof>Pediatrics international, 2019-02, Vol.61 (2), p.152-157</ispartof><rights>2018 Japan Pediatric Society</rights><rights>This article is protected by copyright. All rights reserved.</rights><rights>2019 Japan Pediatric Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3776-eca738adad4ae69ce9d01b0bd93dde94aaa28e74eb8f141b3d5d1ac943619ef3</citedby><cites>FETCH-LOGICAL-c3776-eca738adad4ae69ce9d01b0bd93dde94aaa28e74eb8f141b3d5d1ac943619ef3</cites><orcidid>0000-0003-2880-883X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fped.13746$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fped.13746$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30523661$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shiraishi, Jun</creatorcontrib><creatorcontrib>Kusuda, Satoshi</creatorcontrib><creatorcontrib>Cho, Kazutoshi</creatorcontrib><creatorcontrib>Nakao, Atsushi</creatorcontrib><creatorcontrib>Hiroma, Takehiko</creatorcontrib><creatorcontrib>Sugiura, Hiroshi</creatorcontrib><creatorcontrib>Suzuki, Satoshi</creatorcontrib><creatorcontrib>Oshiro, Makoto</creatorcontrib><creatorcontrib>Yoshimoto, Seiji</creatorcontrib><creatorcontrib>Watabe, Shinichi</creatorcontrib><title>Standardization of nitric oxide inhalation in extremely preterm infants in Japan</title><title>Pediatrics international</title><addtitle>Pediatr Int</addtitle><description>Background
In perinatal medicine, inhaled nitric oxide (iNO) has been an important tool for the treatment of full‐term and late‐preterm infants with persistent pulmonary hypertension of the newborn (PPHN) and hypoxemic respiratory failure (HRF). Its use in more premature infants, however, is controversial. To evaluate the current clinical practices regarding use of acute iNO in extremely preterm infants, a nationwide survey was conducted in Japan.
Methods
A questionnaire survey was conducted from May to September, 2015. Questionnaires about PPHN and iNO treatment were sent to the doctor in charge of the neonatal care unit in 213 perinatal medical centers (PMC) that possessed iNO equipment in Japan.
Results
A total of 143 of the 213 PMC provided responses (67.1%). A diagnosis of PPHN was made exclusively on echocardiography in all PMC. On definitive PPHN diagnosis, iNO was selected in the majority of the PMC (72%) and started from ≤10 p.p.m. in most PMC (49.7%) for extremely preterm infants. During iNO therapy, cardiac function was checked on echocardiography by a neonatologist every ≤8 h. iNO weaning was started when differential peripheral oxygen saturation (SpO2) disappeared, or when SpO2 reached 100% and so on. After iNO concentration reached 5 p.p.m., it was decreased gradually and carefully in five steps, taking 12–24 h to go from 5 to 0 p.p.m.
Conclusions
Inhaled nitric oxide was predominantly used in extremely preterm infants as early rescue therapy for PPHN based on echocardiography performed by a neonatologist.</description><subject>Diagnosis</subject><subject>Echocardiography</subject><subject>Health care facilities</subject><subject>Infants</subject><subject>Inhalation</subject><subject>low birthweight</subject><subject>Neonates</subject><subject>Newborn babies</subject><subject>Nitric oxide</subject><subject>Oxygen content</subject><subject>Pediatrics</subject><subject>persistent pulmonary hypertension of the newborn</subject><subject>Premature babies</subject><subject>Respiration</subject><subject>respiratory distress syndrome</subject><subject>Respiratory failure</subject><subject>Respiratory therapy</subject><subject>Standardization</subject><subject>Weaning</subject><issn>1328-8067</issn><issn>1442-200X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp10MtKxDAUBuAgipfRhS8gBTe6qCZN2iRLGccbgoIu3JXT5hQjbVqTDjo-vdHqRjCbhHM-fsJPyD6jJyye0wHNCeNSFGtkmwmRpRmlT-vxzTOVKlrILbITwgulVEklNskWp3nGi4Jtk_uHEZwBb-wHjLZ3Sd8kzo7e1kn_bg0m1j1DO62sS_B99Nhhu0oGjyP6Lg4bcGP4Wt7AAG6XbDTQBtz7uWfk8WLxOL9Kb-8ur-dnt2nNpSxSrEFyBQaMACx0jdpQVtHKaG4MagEAmUIpsFINE6ziJjcMai14wTQ2fEaOptjB969LDGPZ2VBj24LDfhnKjOW5ZkIqFenhH_rSL72Ln4tK5VpnTOZRHU-q9n0IHpty8LYDvyoZLb9aLmPL5XfL0R78JC6rLk5_5W-tEZxO4M22uPo_qbxfnE-Rn2u4h2g</recordid><startdate>201902</startdate><enddate>201902</enddate><creator>Shiraishi, Jun</creator><creator>Kusuda, Satoshi</creator><creator>Cho, Kazutoshi</creator><creator>Nakao, Atsushi</creator><creator>Hiroma, Takehiko</creator><creator>Sugiura, Hiroshi</creator><creator>Suzuki, Satoshi</creator><creator>Oshiro, Makoto</creator><creator>Yoshimoto, Seiji</creator><creator>Watabe, Shinichi</creator><general>Blackwell Publishing Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2880-883X</orcidid></search><sort><creationdate>201902</creationdate><title>Standardization of nitric oxide inhalation in extremely preterm infants in Japan</title><author>Shiraishi, Jun ; Kusuda, Satoshi ; Cho, Kazutoshi ; Nakao, Atsushi ; Hiroma, Takehiko ; Sugiura, Hiroshi ; Suzuki, Satoshi ; Oshiro, Makoto ; Yoshimoto, Seiji ; Watabe, Shinichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3776-eca738adad4ae69ce9d01b0bd93dde94aaa28e74eb8f141b3d5d1ac943619ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Diagnosis</topic><topic>Echocardiography</topic><topic>Health care facilities</topic><topic>Infants</topic><topic>Inhalation</topic><topic>low birthweight</topic><topic>Neonates</topic><topic>Newborn babies</topic><topic>Nitric oxide</topic><topic>Oxygen content</topic><topic>Pediatrics</topic><topic>persistent pulmonary hypertension of the newborn</topic><topic>Premature babies</topic><topic>Respiration</topic><topic>respiratory distress syndrome</topic><topic>Respiratory failure</topic><topic>Respiratory therapy</topic><topic>Standardization</topic><topic>Weaning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shiraishi, Jun</creatorcontrib><creatorcontrib>Kusuda, Satoshi</creatorcontrib><creatorcontrib>Cho, Kazutoshi</creatorcontrib><creatorcontrib>Nakao, Atsushi</creatorcontrib><creatorcontrib>Hiroma, Takehiko</creatorcontrib><creatorcontrib>Sugiura, Hiroshi</creatorcontrib><creatorcontrib>Suzuki, Satoshi</creatorcontrib><creatorcontrib>Oshiro, Makoto</creatorcontrib><creatorcontrib>Yoshimoto, Seiji</creatorcontrib><creatorcontrib>Watabe, Shinichi</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shiraishi, Jun</au><au>Kusuda, Satoshi</au><au>Cho, Kazutoshi</au><au>Nakao, Atsushi</au><au>Hiroma, Takehiko</au><au>Sugiura, Hiroshi</au><au>Suzuki, Satoshi</au><au>Oshiro, Makoto</au><au>Yoshimoto, Seiji</au><au>Watabe, Shinichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Standardization of nitric oxide inhalation in extremely preterm infants in Japan</atitle><jtitle>Pediatrics international</jtitle><addtitle>Pediatr Int</addtitle><date>2019-02</date><risdate>2019</risdate><volume>61</volume><issue>2</issue><spage>152</spage><epage>157</epage><pages>152-157</pages><issn>1328-8067</issn><eissn>1442-200X</eissn><abstract>Background
In perinatal medicine, inhaled nitric oxide (iNO) has been an important tool for the treatment of full‐term and late‐preterm infants with persistent pulmonary hypertension of the newborn (PPHN) and hypoxemic respiratory failure (HRF). Its use in more premature infants, however, is controversial. To evaluate the current clinical practices regarding use of acute iNO in extremely preterm infants, a nationwide survey was conducted in Japan.
Methods
A questionnaire survey was conducted from May to September, 2015. Questionnaires about PPHN and iNO treatment were sent to the doctor in charge of the neonatal care unit in 213 perinatal medical centers (PMC) that possessed iNO equipment in Japan.
Results
A total of 143 of the 213 PMC provided responses (67.1%). A diagnosis of PPHN was made exclusively on echocardiography in all PMC. On definitive PPHN diagnosis, iNO was selected in the majority of the PMC (72%) and started from ≤10 p.p.m. in most PMC (49.7%) for extremely preterm infants. During iNO therapy, cardiac function was checked on echocardiography by a neonatologist every ≤8 h. iNO weaning was started when differential peripheral oxygen saturation (SpO2) disappeared, or when SpO2 reached 100% and so on. After iNO concentration reached 5 p.p.m., it was decreased gradually and carefully in five steps, taking 12–24 h to go from 5 to 0 p.p.m.
Conclusions
Inhaled nitric oxide was predominantly used in extremely preterm infants as early rescue therapy for PPHN based on echocardiography performed by a neonatologist.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>30523661</pmid><doi>10.1111/ped.13746</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-2880-883X</orcidid></addata></record> |
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| language | eng |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Diagnosis Echocardiography Health care facilities Infants Inhalation low birthweight Neonates Newborn babies Nitric oxide Oxygen content Pediatrics persistent pulmonary hypertension of the newborn Premature babies Respiration respiratory distress syndrome Respiratory failure Respiratory therapy Standardization Weaning |
| title | Standardization of nitric oxide inhalation in extremely preterm infants in Japan |
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