Survey of the national clinical practice of inhaled nitric oxide in preterm infants in China

Background: To help understand the current clinical practice and provide a reference for the quality improvement of iNO in preterm infants in China. Methods A survey on iNO use in preterm infants in neonatal intensive care units was sent to healthcare providers and conducted from January to February 2021. Results Of 678 people participated in this survey, 638 were finally included in the analysis. There was no statistical difference (P > 0.05) in iNO use in infants with a gestational age of 28–36 weeks among different types of hospitals; however, iNO use significantly differed in infants with a gestational age of < 28 weeks (P < 0.001). The younger the gestational age of preterm infants, the fewer the respondents who agreed with its use, with only 26.15% of respondents choosing to use iNO in neonates with a gestational age of < 28 weeks. Hypoxic respiratory failure combined with persistent pulmonary hypertension was the main indication for iNO. The majority of investigators (70.77%) used 20 ppm as the initial concentration of iNO therapy in preterm infants. Conclusion iNO has been used on preterm infants in some hospitals in China. High-quality clinical evidence is needed to further evaluate the dose, procedure, effectiveness, and safety of iNO in preterm infants.