2005 OPEN FORUM Abstracts
INHALED NITRIC OXIDE UTILIZATION IN A LARGE PEDIATRIC MEDICAL CENTER
Jenni L. Raake, MBA, RRT, NPS and Scott Pettinichi, MEd, RRT, NPS Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
Introduction: Inhaled Nitric Oxide (INO) first gained Food and Drug Administration approval in 1999 for term or near term neonates with hypoxic respiratory failure or pulmonary hypertension. Its aim of "on - label" therapy was to improve oxygenation and reduce the need for Extracorporeal Membrane Oxygenation. Based on our physician orders, we hypothesized that INO was primarily "off - label" in our institution.
Methods: We performed a 30 month retrospective utilization review from December, 2002 to April, 2005 of INO use in Newborn, Pediatric, Cardiac ICU, External Transport Team, and the Cardiac Catheterization Laboratory. Respiratory Care Department records were examined, determining the clinical services using INO, and the volume of INO therapy hours delivered by these services.
Results: INO use was most prevalent in the Cardiac ICU with over 13,000 hours of therapy, Newborn ICU provided over 10,000 hours, followed by Pediatric ICU at around 1,000 hours. (See figure below). There was minimal use of INO by either the External Transport Team or the Cardiac Catheterization Laboratory.
Conclusion: While the Newborn ICU provides a significant amount of INO therapy, the Cardiac ICU delivers more INO therapy than all clinical services combined. Therefore, INO utilization in our institution is primarily off-label.