Prolonged Outcomes After Nitric Oxide (PrONOx)

This study has been completed.
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by (Responsible Party):
Derek C. Angus, MD, MPH, University of Pittsburgh Identifier:
First received: October 4, 2005
Last updated: May 12, 2016
Last verified: May 2016
The purpose of this study is to look at the long term consequences of prematurity in infants treated with inhaled nitric oxide (iNO) while in the neonatal intensive care unit.

Condition Intervention Phase
Lung Diseases
Bronchopulmonary Dysplasia
Premature Birth
Developmental Disabilities
Developmental Delay Disorders
Other: Long Term Follow-Up
Phase 3

Study Type: Observational
Study Design: Time Perspective: Prospective
Official Title: Study of the Long-term Outcomes of Nitric Oxide for Ventilated Premature Babies

Resource links provided by NLM:

Further study details as provided by University of Pittsburgh:

Primary Outcome Measures:
  • Assess the cost-effectiveness of iNO in ventilated premature infants using: long term clinical and childhood developmental outcomes; family impact; and healthcare costs of prematurity-associated respiratory failure [ Time Frame: Five Years ] [ Designated as safety issue: No ]

Enrollment: 652
Study Start Date: December 2002
Study Completion Date: November 2008
Primary Completion Date: November 2008 (Final data collection date for primary outcome measure)
Intervention Details:
    Other: Long Term Follow-Up
    Extended and enhance the follow-up of the NHLBI iNO RCT by assessing the effects of iNO use on: 1.) long term clinical and childhood developmental outcomes; 2.) family impact, and; 3.) healthcare costs of prematurity-associated respiratory failure.
Detailed Description:

Prematurity-associated respiratory failure is a growing public health problem. Although mortality has dropped with advances in perinatal care, this condition consumes considerable healthcare resources and is increasingly associated with worrisome long-term morbidity, developmental delay, and family burden. Inhaled nitric oxide (iNO), a selective pulmonary vasodilator that improves short-term outcomes in term neonates with respiratory failure, may benefit premature infants. Consequently, a NHLBI-funded randomized controlled trial (iNO RCT- NHLBI U01 HL064857) is assessing the effect of iNO on the combined end-point of mortality or oxygen dependency at 36 weeks post conceptional age in 800 infants with prematurity-associated respiratory failure.

However, prematurity-associated respiratory failure has a different etiology from respiratory failure in term infants and the wide array of long-term consequences that may be affected by iNO are not captured under the existing study design.

We therefore are extending and enhance the follow-up of the NHLBI iNO RCT. Specifically, we are assessing the effects of INO use on: #1. - long-term clinical and childhood developmental outcomes; #2. - family burden, and; #3. - healthcare costs of prematurity-associated respiratory failure. Under aim #4, we will use data from aims #1-3 to assess the cost-effectiveness of iNO in ventilated premature infants.

We are achieving these aims by augmenting the NHLBI iNO RCT data collection with: i.) survival follow-up for an average of 4 1/2 years; ii.) comprehensive, standardized follow-up clinic visits at 1, 2, 3 and 4 1/2 years to assess clinical outcomes, childhood development, and family burden; iii.) structured telephone interviews with parents every 3 months in year 1 and every 6 months thereafter for an average of 4½ years to assess chronic morbidity and post-discharge healthcare use; iv.) collection of detailed hospital bills for the primary hospitalization, and; v.) a comprehensive analysis plan.

This study will allow us to determine the long-term consequences of iNO therapy in this condition, aiding clinicians, families, and policymakers and immediately affecting care of critically ill infants. By combining with the NHLBI iNO RCT, we take advantage of an important opportunity to gather prospective long-term outcome data in a randomized fashion. Our proposal will significantly increase the return on investment in the RCT through a greater understanding of the impact of iNO therapy from a societal perspective. Neonatal intensive care has changed dramatically in the last ten years. This study will also provide contemporary information on the long-term outcomes of prematurity-associated respiratory failure following modern management. Finally, our data will allow assessment of the robustness of early proxies for subsequent outcomes, key for future study design in this area.


Ages Eligible for Study:   up to 48 Hours
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population
Neonatal intensive care patients - those with prematurity-associated respiratory failure following modern management.

Inclusion Criteria:

  • Enrolled in "Inhaled NO for the Prevention of Chronic Lung Disease" trial ( Identifier: NCT00006401).

Exclusion Criteria:

  • Did not consent to extended follow-up.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00234247

Sponsors and Collaborators
University of Pittsburgh
National Heart, Lung, and Blood Institute (NHLBI)
Principal Investigator: Derek C Angus, MD, MPH University of Pittsburgh
  More Information

Additional Information:
Responsible Party: Derek C. Angus, MD, MPH, Chair, Critical Care Medicine, University of Pittsburgh Identifier: NCT00234247     History of Changes
Other Study ID Numbers: R01HL069991  1U01HL064857-01A1 
Study First Received: October 4, 2005
Last Updated: May 12, 2016
Health Authority: United States: Institutional Review Board

Additional relevant MeSH terms:
Developmental Disabilities
Bronchopulmonary Dysplasia
Lung Diseases
Premature Birth
Infant, Newborn, Diseases
Infant, Premature, Diseases
Lung Injury
Mental Disorders
Neurodevelopmental Disorders
Obstetric Labor Complications
Obstetric Labor, Premature
Pregnancy Complications
Respiratory Tract Diseases
Ventilator-Induced Lung Injury
Nitric Oxide
Anti-Asthmatic Agents
Autonomic Agents
Bronchodilator Agents
Endothelium-Dependent Relaxing Factors
Free Radical Scavengers
Molecular Mechanisms of Pharmacological Action
Neurotransmitter Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Protective Agents
Respiratory System Agents
Vasodilator Agents processed this record on May 26, 2016