RecruitingPhase 4NCT05213676

De-implementing Inhaled Nitric Oxide for Congenital Diaphragmatic Hernia

Inhaled Nitric Oxide (iNO) for Congenital Diaphragmatic Hernia (CDH) - The "NoNO Trial" - a Multi-center, De-implementation, Stepped-wedge, Cluster-randomized Trial Within an Established Collaborative


Sponsor

The University of Texas Health Science Center, Houston

Enrollment

600 participants

Start Date

Nov 1, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

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.


Eligibility

Min Age: 0 MonthsMax Age: 1 Month

Plain Language Summary

Simplified for easier understanding

This study is testing whether it is safe to reduce the use of inhaled nitric oxide (a gas used to help the lungs work better) in newborns with congenital diaphragmatic hernia (CDH) — a birth defect where the abdominal organs push into the chest, preventing the lungs from developing properly. The study aims to determine if babies do just as well with less of this treatment. **You may be eligible if...** - Your baby was born with congenital diaphragmatic hernia (CDH) and is a live birth - The hernia is of the Bochdalek type (back of the diaphragm) - Diagnosis was made before 1 month of age - Your baby was born at or transferred to a participating hospital within the first week of life **You may NOT be eligible if...** - CDH was diagnosed after 1 month of age - The hernia is of the Morgagni type (front/center of the diaphragm) - Your baby was transferred to a participating center after 1 week of age - Inhaled nitric oxide is not available at the treating hospital Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGInhaled Nitric Oxide (iNO) use

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.

OTHERDe-implementation of Inhaled Nitric Oxide (iNO) use

The center will stop using iNO in the initial resuscitation period (defined as birth through stabilization and CDH repair).


Locations(19)

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

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NCT05213676


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