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A review of the use of inhaled nitric oxide in the PICU at Red Cross Children's Hospital, 2011-2015: A retrospective cohort study
Background: Inhaled Nitric Oxide (iNO) functions as a selective pulmonary vasodilator. It is an expensive treatment that is often employed as rescue therapy for refractory hypoxaemia in acute respiratory distress syndrome (ARDS) and pulmonary hypertension (PHT) following cardiac surgery. Objectives:...
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| Format: | Thesis |
| Language: | English |
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Department of Paediatrics and Child Health
2020
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| _version_ | 1867613210584023040 |
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| access_status_str | Open Access |
| author | Padayachee, Sandhia |
| author2 | Salie, Shamiel |
| author_browse | Padayachee, Sandhia Salie, Shamiel |
| author_facet | Salie, Shamiel Padayachee, Sandhia |
| author_sort | Padayachee, Sandhia |
| collection | Thesis |
| description | Background: Inhaled Nitric Oxide (iNO) functions as a selective pulmonary vasodilator. It is an expensive treatment that is often employed as rescue therapy for refractory hypoxaemia in acute respiratory distress syndrome (ARDS) and pulmonary hypertension (PHT) following cardiac surgery. Objectives: To describe the response to treatment with iNO. Secondary observations were deaths, comorbidities of the patients treated, lengths of treatment and admission, and the cost of treatment. Methods: A retrospective descriptive study of all patients treated with iNO in the Paediatric Intensive Care Unit (PICU) at Red Cross War Memorial Children’s Hospital (RCWMCH) from 2011- 2015. Results: A total of 140 patients were treated with iNO during this time period, 82 were for PHT following cardiac surgery, 53 for ARDS and 5 for PPHN. A response to treatment was observed in 64% of the cohort as a whole, 80% of those with PPHN, 67% of those with PHT post-cardiac surgery, and 64% of those with ARDS. A longer duration of ICU and hospital admission, and higher in hospital mortality (53%) was seen in the group with ARDS, in particular those with adenoviral infection (63%), when compared to patients treated for PHT (18%) and for PPHN (20%). There is no protocol in place guiding the use of iNO in our unit, and it was found that response to treatment was not being objectively measured and documented and that practise varied between clinicians. Conclusions: Considering the cost of treatment and lack of evidence to support beneficial effects of iNO therapy, its continued use in our resource poor setting should be guided by protocol. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/30807 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:31.718Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | Department of Paediatrics and Child Health |
| publisherStr | Department of Paediatrics and Child Health |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/30807 A review of the use of inhaled nitric oxide in the PICU at Red Cross Children's Hospital, 2011-2015: A retrospective cohort study Padayachee, Sandhia Salie, Shamiel Nitric Oxide iNO Pulmonary Hypertension Children PICU Background: Inhaled Nitric Oxide (iNO) functions as a selective pulmonary vasodilator. It is an expensive treatment that is often employed as rescue therapy for refractory hypoxaemia in acute respiratory distress syndrome (ARDS) and pulmonary hypertension (PHT) following cardiac surgery. Objectives: To describe the response to treatment with iNO. Secondary observations were deaths, comorbidities of the patients treated, lengths of treatment and admission, and the cost of treatment. Methods: A retrospective descriptive study of all patients treated with iNO in the Paediatric Intensive Care Unit (PICU) at Red Cross War Memorial Children’s Hospital (RCWMCH) from 2011- 2015. Results: A total of 140 patients were treated with iNO during this time period, 82 were for PHT following cardiac surgery, 53 for ARDS and 5 for PPHN. A response to treatment was observed in 64% of the cohort as a whole, 80% of those with PPHN, 67% of those with PHT post-cardiac surgery, and 64% of those with ARDS. A longer duration of ICU and hospital admission, and higher in hospital mortality (53%) was seen in the group with ARDS, in particular those with adenoviral infection (63%), when compared to patients treated for PHT (18%) and for PPHN (20%). There is no protocol in place guiding the use of iNO in our unit, and it was found that response to treatment was not being objectively measured and documented and that practise varied between clinicians. Conclusions: Considering the cost of treatment and lack of evidence to support beneficial effects of iNO therapy, its continued use in our resource poor setting should be guided by protocol. 2020-01-23T13:04:51Z 2020-01-23T13:04:51Z 2019 2020-01-22T07:36:45Z Master Thesis Masters MMed http://hdl.handle.net/11427/30807 eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences |
| spellingShingle | Nitric Oxide iNO Pulmonary Hypertension Children PICU Padayachee, Sandhia A review of the use of inhaled nitric oxide in the PICU at Red Cross Children's Hospital, 2011-2015: A retrospective cohort study |
| thesis_degree_str | Master's |
| title | A review of the use of inhaled nitric oxide in the PICU at Red Cross Children's Hospital, 2011-2015: A retrospective cohort study |
| title_full | A review of the use of inhaled nitric oxide in the PICU at Red Cross Children's Hospital, 2011-2015: A retrospective cohort study |
| title_fullStr | A review of the use of inhaled nitric oxide in the PICU at Red Cross Children's Hospital, 2011-2015: A retrospective cohort study |
| title_full_unstemmed | A review of the use of inhaled nitric oxide in the PICU at Red Cross Children's Hospital, 2011-2015: A retrospective cohort study |
| title_short | A review of the use of inhaled nitric oxide in the PICU at Red Cross Children's Hospital, 2011-2015: A retrospective cohort study |
| title_sort | review of the use of inhaled nitric oxide in the picu at red cross children s hospital 2011 2015 a retrospective cohort study |
| topic | Nitric Oxide iNO Pulmonary Hypertension Children PICU |
| url | http://hdl.handle.net/11427/30807 |
| work_keys_str_mv | AT padayacheesandhia areviewoftheuseofinhalednitricoxideinthepicuatredcrosschildrenshospital20112015aretrospectivecohortstudy AT padayacheesandhia reviewoftheuseofinhalednitricoxideinthepicuatredcrosschildrenshospital20112015aretrospectivecohortstudy |