Pulmonary Vasodilator Use in Very Preterm Infants in United States Children's Hospitals

Overview

Journal Res Sq

Date 2024 Dec 16

PMID 39678327

Authors

Tomas Vega

Matthew Huber

Erik Jensen

Catherine Avitabile

Scott Lorch

Kathleen Gibbs

Michael OByrne

David Frank

Nicolas Bamat

Affiliations

Soon will be listed here.

Abstract

Objectives: To describe common pulmonary vasodilators (PV), exposure timing, and characteristics associated to their use in very preterm (VP) infants.

Study Design: Observational study of VP infants discharged from U.S. children's hospitals (2011-2021). PV exposures during hospitalization were identified, and multivariable modeling determined characteristics associated with exposure.

Results: Among 37,428 infants, 6.3% received PV. Early inhaled nitric oxide (iNO) and late sildenafil were most common. Early exposure was associated with lower gestational age, aOR: 9.2 (7.3-11.7), 22-25 vs. 29-31 weeks) and small for gestational age (SGA), 2.3 (2.0-2.7). Late exposure was associated with bronchopulmonary dysplasia (BPD) grade, 26.2 (16.8-40.9), grade 3 vs. no BPD) and early PV exposure, 3.7 (2.9-4.8).

Conclusions: Early iNO and late sildenafil are used in VP infants despite limited evidence. Prospective early studies enrolling extremely preterm or SGA infants and late studies enrolling infants with early PV exposure or high-grade BPD would target current evidence gaps.

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