224 - Inhaled Nitric Oxide and Congenital Diaphragmatic Hernia Treated with ECLS: A Propensity Score Analysis

Poster Number: 224
Publication Number: 224.221

Sharada H. Gowda, Baylor College of Medicine, Houston, TX, United States; Ahmed Almaazmi, Baylor College of Medicine, Houston, TX, United States; Joseph Hagan, Baylor College of Medicine, Houston, TX, United States; Emily Niemyjski, Baylor College of Medicine, Houston, TX, United States; Caraciolo J. Fernandes, Baylor College of Medicine, Houston, TX, United States; Yigit Guner, UC Irvine, Irvine, CA, United States

Background: Inhaled nitric oxide (iNO) has been shown to benefit neonates with pulmonary hypertension (PH) secondary to respiratory distress syndrome. However, iNO has not shown any measurable benefit for infants with congenital diaphragmatic hernia (CDH) requiring extracorporeal life support (ECLS). To further test this, we conducted a retrospective analysis/Propensity score to mimic a randomized control study.

Objective: We sought to determine whether pre-ECLS use of iNO decreased mortality.

Design/Methods: Neonates who underwent ECLS for CDH were identified within the Extracorporeal Life Support Organization (ELSO) Registry. Patients were categorized into those treated with iNO versus not prior to initiating ECLS. Patients were matched 1:1 for severity based on pre-ECLS covariates using the propensity score (PS) for the iNO treatment as a separate covariate

Results: There were a total of 2892 infants with an overall mortality of47.3%Utilization of iNO prior to ECLS was 83.1%. Use of iNO was not associated with differences in mortality (OR = 1.161, 95% CI: 0.942 - 1.431, p = 0.162).Conclusion(s): Pre-ECLS use of iNO did not decrease mortality in CDH patients.
Comparison of the characteristics of patients treated versus not treated with iNO before and after propensity score matching.Table 1
Association of iNO with mortality for each analytical approach.Table 2