Child health status, neurodevelopmental outcome, and parental satisfactionin a randomized, controlled trial of nitric oxide for persistent pulmonaryhypertension of the newborn
M. Ellington et al., Child health status, neurodevelopmental outcome, and parental satisfactionin a randomized, controlled trial of nitric oxide for persistent pulmonaryhypertension of the newborn, PEDIATRICS, 107(6), 2001, pp. 1351-1356
Objective. To describe health and neurodevelopmental outcomes and parental
satisfaction with hospital care among surviving intervention and control en
rollees in a randomized, controlled trial of nitric oxide for persistent pu
lmonary hypertension of the newborn (PPHN).
Methods. All surviving enrollees 1 to 4 years of age were eligible for foll
ow-up. Outcomes were assessed by telephone using a trained interviewer and
standardized instruments. Domains assessed included parental report of spec
ific conditions and hospital use, rating of general health, cognitive and m
otor development, behavior problems, temperament, and satisfaction with the
hospital stay. Fisher's exact test and the Wilcoxon rank sum test assessed
differences between intervention and control infants.
Results. Interviews were completed on 60 of 83 survivors (72%). Eighteen fa
milies (22%) could not be located, 2 (2%) were non-English-speaking, and 3
(4%) declined participation. No postdischarge deaths were ascertained. Amon
g those interviewed, race, income, and education of parents of intervention
and controls were comparable, as were entry oxygenation index, extracorpor
eal oxygenation utilization, and days of hospitalization. No differences we
re found in pulmonary, neurologic, cognitive, behavioral, or neurosensory o
utcomes; hospital readmission rates; or parental ratings of child's health.
The overall neurologic handicap rate was 15%. The rate of hearing deficit
was 7%. The rate of significant behavioral problems was 26%. Levels of sati
sfaction expressed were high for each group. No differences in parental rat
ings were found between the 2 groups.
Conclusions. No adverse health or neurodevelopmental outcomes have been obs
erved among infants treated with nitric oxide for PPHN. The parents of the
critically ill infants enrolled in our clinical trial welcomed their child'
s inclusion and all expressed satisfaction with the care that their child r
eceived while at a tertiary care hospital. Enrollment in either arm of this
randomized, controlled trial did not seem to affect parental satisfaction
with the hospital care that their child received.