title: Inhaled nitric oxide use in preterm infants in California neonatal intensive care units.
abstract: To describe inhaled nitric oxide (iNO) exposure in preterm infants and variation in neonatal intensive care unit (NICU) use.
  
  
  
  This was a retrospective cohort study of infants, 22 to 33+6/7 weeks of gestational age (GA), during 2005 to 2013. Analyses were stratified by GA and included population characteristics, iNO use over time and hospital variation.
  
  
  
  Of the 65 824 infants, 1718 (2.61%) received iNO. Infants, 22 to 24+6/7 weeks of GA, had the highest incidence of iNO exposure (6.54%). Community NICUs (n=77, median hospital use rate 0.7%) used less iNO than regional NICUs (n=23, median hospital use rate 5.8%). In 22 to 24+6/7 weeks of GA infants, the median rate in regional centers was 10.6% (hospital interquartile range 3.8% to 22.6%).
  
  
  
  iNO exposure varied with GA and hospital level, with the most use in extremely premature infants and regional centers. Variation reflects a lack of consensus regarding the appropriate use of iNO for preterm infants.
authors.affiliation: Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: S C
authors.initials: SC
authors.lastname: Handley
authors.affiliation: Department of Pediatrics, University of California, Davis, Davis, CA, USA.
authors.forename: R H
authors.initials: RH
authors.lastname: Steinhorn
authors.affiliation: Department of Pediatrics, Loma Linda University, Loma Linda, CA, USA.
authors.forename: A O
authors.initials: AO
authors.lastname: Hopper
authors.affiliation: Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, CA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Govindaswami
authors.affiliation: Department of Pediatrics, Kaiser Permanente, Fontana, CA, USA.
authors.forename: D R
authors.initials: DR
authors.lastname: Bhatt
authors.affiliation: Department of Pediatrics, Stanford University, Stanford, CA, USA.
authors.forename: K P
authors.initials: KP
authors.lastname: Van Meurs
authors.affiliation: Department of Pediatrics, Stanford University, Stanford, CA, USA.|Oak Ridge Institute for Research and Education (ORISE), Oak Ridge, TN, USA.|US Food and Drug Administration, Silver Spring, MD, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Ariagno
authors.affiliation: Department of Pediatrics, Stanford University, Stanford, CA, USA.|California Perinatal Quality Care Collaborative (CPQCC), Stanford, CA, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Gould
authors.affiliation: Department of Pediatrics, Stanford University, Stanford, CA, USA.|California Perinatal Quality Care Collaborative (CPQCC), Stanford, CA, USA.
authors.forename: H C
authors.initials: HC
authors.lastname: Lee
mesh_terms: D000280:Administration, Inhalation; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002140:California; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000401:mortality; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009569:Nitric Oxide / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D001993:Bronchodilator Agents; D009569:Nitric Oxide