De-implementing Inhaled Nitric Oxide for Congenital Diaphragmatic Hernia

Description

The purpose of this study is to determine if de-implementation of inhaled nitric oxide (iNO) in the post-natal resuscitation/stabilization phase affects the composite outcome of extracorporeal life support (ECLS) use and/or mortality, as well as ECLS use, mortality, and/or oxygenation in congenital diaphragmatic hernia (CDH) newborns and to establish the cost-effectiveness of de-implementing iNO as a therapy in the postnatal resuscitation/stabilization phase of CDH management, which will be assessed as the incremental health system costs (savings) per prevented ECLS use and/or death.

Interventions

• Inhaled Nitric Oxide (iNO) use (Drug)
  The center will use iNO per their usual protocol in the initial resuscitation period (defined as birth through stabilization and CDH repair). No center will alter any component of their standard clinical practice guideline or protocol governing CDH care.
• De-implementation of Inhaled Nitric Oxide (iNO) use (Other)
  The center will stop using iNO in the initial resuscitation period (defined as birth through stabilization and CDH repair).

Eligibility criteria

Conditions

Locations

• University of Alabama & Children's Hospital of Alabama (UAB-CoA) — Birmingham, Alabama, United States
• University of Arkansas & Arkansas Children's Hospital (UA-ACH) — Little Rock, Arkansas, United States
• University of California-Irvine & Children's Hospital of Orange County (UC-CHOC) — Irvine, California, United States
• University of Southern California & Children's Hospital Los Angeles (USC-CHLA) — Los Angeles, California, United States
• Stanford University & Lucile Packard Children's Hospital (Stanford-LPCH) — Palo Alto, California, United States
• University of California, San Diego & Rady Children's Hospital (UCSD-Rady) — San Diego, California, United States
• University of Colorado & Children's Hospital of Colorado (CU-CHC) — Aurora, Colorado, United States
• Emory University & Children's Healthcare of Atlanta (CHOA) — Atlanta, Georgia, United States
• Indiana University & Riley Children's Hospital (IU-RiCH) — Indianapolis, Indiana, United States
• University of Louisville & Norton Children's Hospital (UL-NCH) — Louisville, Kentucky, United States
• Harvard University & Boston Children's Hospital (Harvard-BCH) — Boston, Massachusetts, United States
• University of Michigan & CS Mott Children's Hospital (UM-CSMott) — Ann Arbor, Michigan, United States
• Randall Children's Hospital-Portland (RCH) — Portland, Oregon, United States
• Medical University of South Carolina Children's Health (MUSC) — Charleston, South Carolina, United States
• University of Tennessee & LeBonheur Children's Hospital (UT-LBCH) — Memphis, Tennessee, United States
• Vanderbilt University & Vanderbilt University Medical Center (VUMC) — Nashville, Tennessee, United States
• The University of Texas Health Science Center at Houston — Houston, Texas, United States
• University of Utah & Primary Children's Hospital (Utah-PCH) — Salt Lake City, Utah, United States
• University of Washington & Seattle Children's Hospital (UW-SCH) — Seattle, Washington, United States