Truog William E, Castor Cheri A, Sheffield Mark J
Department of Pediatrics, Children's Mercy Hospitals, University of Missouri, Kansas City, MO 64108, USA.
J Perinatol. 2003 Mar;23(2):128-32. doi: 10.1038/sj.jp.7210864.
To determine predictors of sustained response to inhaled nitric oxide (INO) and the financial impact of INO commercialization.
DESIGN/METHODS: We evaluated the records of extra-corporeal membrane oxygenation (ECMO)-eligible infants consecutively treated with INO. We calculated the charges for INO therapy and for ECMO for each patient so treated. PUBLISHED BY ELSEVIER SCIENCE LTD.
In total, 52 (59%) of 88 infants avoided ECMO; all received INO for >48 hours; all survived. A total of 36 infants received ECMO; 21 infants after <24 hours of INO; seven infants after 24 to 48 hours; and eight infants >48 hours of INO; one infant died. In total, 51 infants had sustained responses to INO; 19 infants were nonresponders and 18 were transient responders. Infants with PPHN and those older than 24 hours were more likely to respond to INO. Total INO charges for all 88 infants were $1,048,000. Total ECMO charges for the 36 infants so treated were $1,710,000.
INO has added a charge-saving therapy to selective infants who can avoid ECMO.
确定吸入一氧化氮（INO）持续反应的预测因素以及INO商业化的财务影响。
设计/方法：我们评估了连续接受INO治疗的符合体外膜肺氧合（ECMO）标准的婴儿的记录。我们计算了每位接受该治疗的患者的INO治疗费用和ECMO费用。由爱思唯尔科学有限公司出版。
88名婴儿中共有52名（59%）避免了使用ECMO；所有婴儿接受INO治疗均超过48小时；全部存活。共有36名婴儿接受了ECMO治疗；21名婴儿在INO治疗<24小时后接受ECMO；7名婴儿在INO治疗24至48小时后接受ECMO；8名婴儿在INO治疗>48小时后接受ECMO；1名婴儿死亡。共有51名婴儿对INO有持续反应；19名婴儿无反应，18名婴儿为短暂反应者。患有持续性肺动脉高压（PPHN）的婴儿和年龄大于24小时的婴儿对INO反应的可能性更大。88名婴儿的INO总费用为104.8万美元。接受ECMO治疗的36名婴儿的ECMO总费用为171万美元。
INO为部分可避免使用ECMO的婴儿增加了一种节省费用的治疗方法。
