Neonatal nitric oxide use: predictors of response and financial implications.
OBJECTIVE
To determine predictors of sustained response to inhaled nitric oxide (INO) and the financial impact of INO commercialization.


METHODS
We evaluated the records of extra-corporeal membrane oxygenation (ECMO)-eligible infants consecutively treated with INO. We calculated the charges for INO therapy and for ECMO for each patient so treated. PUBLISHED BY ELSEVIER SCIENCE LTD.


RESULTS
In total, 52 (59%) of 88 infants avoided ECMO; all received INO for >48 hours; all survived. A total of 36 infants received ECMO; 21 infants after <24 hours of INO; seven infants after 24 to 48 hours; and eight infants >48 hours of INO; one infant died. In total, 51 infants had sustained responses to INO; 19 infants were nonresponders and 18 were transient responders. Infants with PPHN and those older than 24 hours were more likely to respond to INO. Total INO charges for all 88 infants were $1,048,000. Total ECMO charges for the 36 infants so treated were $1,710,000.


CONCLUSIONS
INO has added a charge-saving therapy to selective infants who can avoid ECMO.
Truog
William E
WE
Department of Pediatrics, Children's Mercy Hospitals, University of Missouri, Kansas City, MO 64108, USA.
Castor
Cheri A
CA
Sheffield
Mark J
MJ
D003365:Costs and Cost Analysis; D015199:Extracorporeal Membrane Oxygenation / Q000191:economics; D006801:Humans; D007231:Infant, Newborn; D008923:Missouri; D009569:Nitric Oxide / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D012121:Respiration, Artificial / Q000191:economics; D016896:Treatment Outcome
D009569:Nitric Oxide