Search Results (1,276)

This study aimed to evaluate the feasibility of using serious games for the (tele)rehabilitation of children with disabilities affected by the Ukrainian war. Additionally, it provides requirements for technologies that can be used in war-affected areas. Structured interviews and Likert scale assessments were conducted on-site and remotely with patients of the tertiary care facility in Ukraine. All participants used the telerehabilitation platform for motor and cognitive training. Nine serious games were employed, involving trunk tilts, upper limb movements, and head control. By mid-September 2023, 186 positive user experiences were evident, with 89% expressing interest in continued engagement. The platform’s accessibility, affordability, and therapeutic benefits were highlighted. The recommendations from user feedback informed potential enhancements, showcasing the platform’s potential to provide uninterrupted rehabilitation care amid conflict-related challenges. This study suggests that serious games solutions that suit the sociopolitical and economic context offer a promising solution to rehabilitation challenges in conflict zones. The positive user experiences towards using the platform with serious games indicate its potential in emergency healthcare provision. The findings emphasize the role of technology, particularly serious gaming, in mitigating the impact of armed conflicts on children’s well-being, thereby contributing valuable insights to healthcare strategies in conflict-affected regions. Requirements for technologies tailored to the context of challenging settings were defined. Full article

Introduction: Nurses are the largest group of healthcare workers, and healthcare managers should pay attention to the quality of work life and the health and working capacity of nurses in order to ensure a sufficient number of nurses and a stable workforce. Aim: The present study aimed to determine nurses’ quality of work life, work ability index and intention to leave the nursing profession and to examine the associations between nurses’ quality of work life, work ability index and intention to leave the nursing profession. Methods: An online cross-sectional study was conducted. A total of 498 nurses completed the instrument, consisting of demographic data, Brooks’ Quality of Nursing Work Life Survey (BQNWL), Work Ability Index Questionnaire (WAIQ) and questions on their intention to leave their current job or the nursing profession. Results: Most nurses had a moderate quality of work life (QWL) (73.7%) and a good work ability index (WAI) (43.78%). Men (p = 0.047), nurses who study (p = 0.021), nurses who do not have children (p = 0.000) and nurses who do not take care of their parents (p = 0.000) have a statistically significantly higher total WAIQ score. Most nurses (61.1%) had considered changing jobs in the last 12 months, and 36.9% had considered leaving the nursing profession. A statistically significant positive correlation was found between the total BQNWL and the total WAI. The study found no correlation between QWL, WAI and intention to change jobs or leave the profession, which was unexpected. Conclusions: To ensure the provision of necessary nursing care and a healthy working environment for nurses, it is necessary to regularly monitor QWL and WAI and take measures to ensure the highest quality of working life. Further longitudinal and mixed-methods research is needed to understand the relationship between QWL, WAI and intention to leave. Full article

Background/Objectives: Breastmilk offers numerous benefits for the health and development of preterm infants, while prolonged hospitalization may impair neurodevelopment. At our institution, the implementation of enhanced family-centered care (FCC) has enabled earlier discharge of preterm infants. This study aimed to assess the impact of early discharge on breastfeeding and breastmilk provision. Methods: This analysis is based on data from a prospective single-center longitudinal cohort study conducted from October 2020 to November 2023, involving six consecutive cohorts (one baseline and five intervention cohorts; n = 184). FCC was progressively enhanced across cohorts. The primary outcome of the main study was postmenstrual age (PMA) at discharge. In this secondary analysis, breastfeeding and breastmilk provision were assessed at four time points: 4 weeks postnatal age, at discharge, 4 weeks post-discharge, and at 3 months PMA. Results: From baseline to intervention cohort 5, the PMA at discharge declined significantly from 37.8 ± 2.1 to 35.7 ± 0.91 weeks (p = 0.03), while the percentage of infants necessitating home nasogastric tube feeding increased from 6.3% to 66.7% (p < 0.01). The proportion of breastmilk of daily feeding volume remained unchanged at 4 weeks postnatal age (0.66 ± 0.42 vs. 0.9 ± 0.28) and at discharge (0.6 ± 0.45 vs. 0.79 ± 0.36). At 4 weeks post-discharge, 65.8% vs. 62.5% of the infants were on partial or exclusive breastmilk (p = 0.91) feeding. Similarly, the percentage of exclusively breastfed infants at 4 weeks post-discharge (23.7% vs. 19.8%) and at 3 months PMA (20% vs. 28.6%) did not differ significantly between baseline and intervention cohort 5. Conclusions: Early discharge did not reduce breastmilk supply or exclusive breastfeeding. However, the persistently low rate of exclusive breastfeeding post-discharge highlights the need for additional support strategies during and after hospitalization. Full article

Background: Perioperative care is an integral part of the procedure of a surgical operation, with strictly defined rules. The need to upgrade and improve some individual long-term processes aims at optimal patient care and the provision of high-level health services. Therefore, preoperative care is drawn up with new data resulting from the evolution of technology to upgrade the procedures that need improvement. According to the international literature, a factor considered to be of major importance is high preoperative anxiety and its effects on the patient’s postoperative course. High preoperative anxiety is postoperatively responsible for prolonged hospital stays, increased postoperative pain, decreased effect of anesthetic agents, increased amounts of analgesics, delayed healing of surgical wounds, and increased risk of infections. The use of Virtual Reality technology appears as a new method of managing preoperative anxiety. Objective: This study investigates the effect and effectiveness of Virtual Reality (VR) technology in managing preoperative anxiety in adult patients. Methods: A literature review was performed on 193 articles, published between 2017 and 2024, sourced from the scientific databases PubMed and Cochrane, as well as the trial registry ClinicalTrials, with a screening and exclusion process to meet the criterion of investigating VR technology’s effectiveness in managing preoperative anxiety in adult patients. This systematic review was conducted under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Results: Out of the 193 articles, 29 were selected. All articles examined the efficacy of VR in adult patients (≥18) undergoing various types of surgery. The studies represent a total of 2.354 participants from 15 countries. There are two types of VR applications: distraction therapy and patient education. From the studies, 14 (48%) used the distraction VR intervention, 14 (48%) used the training VR intervention, and 1 (4%) used both VR interventions, using a range of validated anxiety scales such as the STAI, VAS-A, APAIS, and HADS. Among the 29 studies reviewed, 25 (86%) demonstrated statistically significant reductions in preoperative anxiety levels following the implementation of VR interventions. VR technology appears to manage preoperative anxiety effectively. It is a non-invasive and non-pharmacological intervention with minimal side effects. Conclusions: Based on the review, the management of preoperative anxiety with VR technology shows good levels of effectiveness. Further investigation of the efficacy by more studies and randomized controlled trials, with a larger patient population, is recommended to establish and universally apply VR technology in the preoperative care process as an effective method of managing preoperative anxiety. Full article

Background: Psychological problems post-stroke can negatively impact stroke survivors. Although general psychological services exist (e.g., NHS Talking Therapies), access remains limited, particularly for individuals with post-stroke communication and cognitive impairments. Stroke service staff report low confidence in managing psychological distress. This study is the first to explore the barriers and facilitators to implementing a novel intervention package comprising a cross-service care pathway and staff training to enhance post-stroke psychological provision. Methods: Staff from stroke and mental health services in four UK regions, recruited through purposive sampling to ensure diversity of services and professional roles, participated in semi-structured interviews or focus groups, guided by the Theoretical Domains Framework (TDF), before and after implementation of the intervention package. Pre-implementation interviews/groups identified anticipated barriers and facilitators to implementation and training needs, informing the development of site-specific intervention packages; post-implementation interviews/groups explored experienced barriers, facilitators and perceptions of the intervention. Interviews underwent thematic analysis using the TDF. Results: Fifty-five staff participated pre-implementation and seventeen post-implementation, representing stroke (e.g., nurse, physiotherapist, consultant) and psychology (e.g., counsellor, psychological therapist) roles across acute, rehabilitation, community, and voluntary services. Challenges anticipated pre-implementation included: limited specialist post-stroke psychological support; low staff confidence; and fragmented service pathways. Post-implementation findings indicated increased staff knowledge and confidence, enhanced screening and referral processes, and stronger inter-service collaboration. Implementation success varied across sites (with some sites showing greater ownership and sustainability of the intervention) and across staff roles (with therapy staff more likely than nursing staff to have received training). Conclusions: Effective implementation of an intervention package to increase psychological provision post-stroke requires staff engagement at all levels across all services. Staff investment influenced ownership of the intervention package, beliefs about priorities and overall enhancement of service capability. Full article

(1) Background: Patient-centered care for individuals with breast cancer requires multidisciplinary cooperation to ensure the appropriate use of medication and prevent medication-related problems. Pharmaceutical care has been associated with improved adherence in breast cancer management, a factor linked to patient outcomes and mortality. This study aims to summarize and explore the provision and utilization of pharmaceutical services for breast cancer patients by pharmacists. (2) Methods: A scoping review was performed to assess the pharmacist’s role in providing pharmaceutical services for patients with breast cancer. A comprehensive review of four databases (PubMed, Ovid Embase, Ovid International Pharmaceutical Abstracts, and Scopus) was completed between 1 January 2012 and 8 April 2025 according to PRISMA-ScR framework. (3) Results: A total of 46 articles met the inclusion criteria, which included RCTs, observatory studies, cohort studies, and reviews. Findings suggest that both clinical and community pharmacists play an important role in prevention, management, and education for breast cancer patients. (4) Conclusions: Pharmacists can improve health outcomes by providing pharmaceutical service in breast cancer care. Optimizing interventions, expanding services, and evaluating long-term cost-effectiveness is needed in the future. Full article

Background/Objectives: Young female cancer survivors often face specific informational needs related to the physical and emotional effects of cancer and its impact on life plans, particularly fertility and parenthood. However, few tools are tailored to assess these needs during this critical life stage. This study aimed to (i) validate a multidimensional measure—the Satisfaction with Information Provided to Young Oncology Patients Scale (SIPYF-CPS)—to assess the specific informational needs of young adult female cancer survivors; and (ii) explore preferences regarding the provision of information and counseling. Methods: A total of 124 women (M[age] = 38.18; SD = 5.49; range 21–45), 76.6% diagnosed with breast cancer, participated in the study. Psychometric analyses included exploratory factor analysis and correlation coefficients to assess reliability and construct validity. Convergent validity was evaluated through standardized measures of anxiety, reproductive concerns, and quality of life. Results: A final 22-item measure demonstrated strong reliability and validity, capturing four factors: (i) Disease-Related Information, (ii) Symptoms and Functional Limitations, (iii) Implications for Fertility and Parenthood, and (iv) Support Services. Participants expressed low satisfaction with information on fertility preservation, sexual health, and support services. Lower satisfaction was moderately associated with higher anxiety and depression while positively related to quality of life. Most participants preferred phased, face-to-face communication throughout the illness trajectory. Conclusions: The SIPYF-CPS is a valid, multidimensional tool that captures the complex and evolving informational needs of young female cancer survivors. Its clinical use may promote earlier, personalized, and emotionally responsive communication—supporting psychological well-being, informed decision-making, and long-term survivorship care. Full article

Background/Objectives: Access to specialized care for patients with cognitive impairment in remote areas is often limited. Despite the increasing adoption of telemedicine, standardized guidelines have not yet been specified. This study aimed to develop a comprehensive protocol for the specialized neurological, neuropsychological, and neuropsychiatric assessment of patients with cognitive disorders in remote areas through telemedicine. Methods: We analyzed data from (i) a comprehensive literature review of the existing recommendations, reliability studies, and telemedicine models for cognitive disorders, (ii) insights from a three-year experience of a specialized telemedicine outpatient clinic for cognitive movement disorders in Greece, and (iii) suggestions coming from dementia specialists experienced in telemedicine (neurologists, neuropsychologists, psychiatrists) who took part in three focus groups. A critical synthesis of the findings was performed in the end. Results: The final protocol included: technical and organizational requirements (e.g., a high-resolution screen and a camera with zoom, room dimensions adequate for gait assessment, a noise-canceling microphone); medical history; neurological, neuropsychiatric, and neuropsychological assessment adapted to videoconferencing; ethical–legal aspects (e.g., data security, privacy, informed consent); clinician–patient interaction (e.g., empathy, eye contact); diagnostic work-up; linkage to other services (e.g., tele-psychoeducation, caregiver support); and instructions for treatment and follow-up. Conclusions: This protocol is expected to serve as an example of good clinical practice and a source for official telemedicine guidelines for cognitive disorders. Ultimate outcomes include the potential enhanced access to specialized care, minimized financial and logistical costs, and the provision of a standardized, effective model for the remote diagnosis, treatment, and follow-up. This model could be applied not only in Greece, but also in other countries with similar healthcare systems and populations living in remote, difficult-to-access areas. Full article

Background/Objectives: Mobile healthcare units (MHUs) comprise flexible, ambulatory healthcare teams that deliver community care services, particularly in underserved or remote areas. In Greece, MHUs were pivotal in epidemiological surveillance during the COVID-19 pandemic and are now evolving into a sustainable and integrated service for much-needed community-based healthcare. To support this expanded role, targeted, competency-based training is essential; however, this can pose challenges, especially in coordinating synchronous learning across geographically dispersed teams and in ensuring engagement using an online format. Methods: A nationwide, online training program was developed to improve the knowledge of the personnel members of the Hellenic National Public Health Organization’s MHUs. This program was structured focusing on four core themes: (i) prevention–health promotion; (ii) provision of care; (iii) social welfare and solidarity initiatives; and (iv) digital health skill enhancement. The program was implemented by the University of Crete’s Center for Training and Lifelong Learning from 16 January to 24 February 2025. A multidisciplinary team of 64 experts delivered 250 h of live and on-demand educational content, including health screenings, vaccination protocols, biomarker monitoring, chronic disease management, treatment adherence, organ donation awareness, counseling on social violence, and eHealth applications. Knowledge acquisition was assessed through a pre- and post-training multiple-choice test related to the core themes. Trainees’ and trainers’ qualitative feedback was evaluated using a 0–10 numerical rating scale (Likert-type). Results: A total of 873 MHU members participated in the study, including both healthcare professionals and administrative staff. The attendance rate was consistently above 90% on a daily basis. The average assessment score increased from 52.8% (pre-training) to 69.8% (post-training), indicating 17% knowledge acquisition. The paired t-test analysis demonstrated that this improvement was statistically significant (t = −8.52, p < 0.001), confirming the program’s effectiveness in enhancing knowledge. As part of the evaluation of qualitative feedback, the program was positively evaluated, with 75–80% of trainees rating key components such as content, structure, and trainer effectiveness as “Very Good” or “Excellent.” In addition, using a 0–10 scale, trainers rated the program relative to organization (9.4/10), content (8.8), and trainee engagement (8.9), confirming the program’s strength and scalability in primary care education. Conclusions: This initiative highlights the effectiveness of a structured, online training program in enhancing MHU knowledge, ensuring standardized, high-quality education that supports current primary healthcare needs. Future studies evaluating whether the increase in knowledge acquisition may also result in an improvement in the personnel’s competencies, and clinical practice will further contribute to assessing whether additional training programs may be helpful. Full article

Background/Objectives: In Germany, the provision of healthcare for post-COVID patients primarily lies with general practitioners (GPs), who often lack the necessary knowledge and skills. As part of the PostCovidCare pilot study (PCC), case management software incorporating a symptom diary was introduced and piloted in n = 10 GP practices with n = 33 included patients involved (September 2022–March 2023). This study aimed to explore patients’ experiences. Methods: Semi-structured telephone interviews were transcribed and analyzed using qualitative content analysis. A total of n = 10 patient interviews were conducted (July–September 2023). Results: Patients’ experiences were heterogeneous. The service was largely structured, involving an extensive initial assessment, follow-up appointments, questionnaires, and support from medical assistants, but technical problems with the symptom diary occurred. The GP consultation played a prominent role. Positive aspects included being actively asked about their symptoms, being given a lot of time, initiating diagnostic and therapeutic measures, and having a closer relationship with their GP. Negative aspects included the time taken, resulting exhaustion, duplication of efforts, and insufficient involvement in the consultation process. Conclusions: The pilot study conducted at an early stage of the post-COVID era demonstrated the basic feasibility of case management in primary care from patients’ perspectives. In addition, for future projects, it is important to integrate patients into the design from the outset, adapt the software to users’ needs, and consider care providers’ perspectives. Full article

Introduction: The rapid adoption of telerehabilitation in physiotherapy and occupational therapy has transformed healthcare delivery, offering new opportunities for patient-centered care. However, its implementation raises critical ethical and equity-related questions that require proactive strategies to ensure fair and responsible practices. This review examines how ethical disparities and equity-related challenges are reflected in the existing literature on telerehabilitation. Objective: To investigate the presence of ethical-disparity and equity-related aspects in the provision of telerehabilitation in physiotherapy and occupational therapy as reflected in the literature. Data Sources: A rapid review methodology was employed to explore ethical and equity-related challenges in telerehabilitation. The search included articles published in English and French between 2010 and 2023 from the Medline and Embase databases. Study Selection: Articles were selected based on their relevance to ethical and equity considerations in telerehabilitation. A total of 1750 sources were initially identified, with 67 articles meeting the eligibility criteria for inclusion in this review. Data Extraction: Data were extracted based on variables such as age, gender, ethnicity, morbidity, cost, privacy, confidentiality, and autonomy. The data extraction and analysis were guided by the Progress Plus and Metaverse Equitable Rehabilitation Therapy frameworks. Data Synthesis: The findings were analyzed and discussed using a narrative synthesis approach. The results highlighted key ethical considerations, including adverse events, patient autonomy, and privacy issues. Equity-related aspects were examined, access to rehabilitation services and gender considerations. Disparities in technology access, socioeconomic status, and ethnicity were also identified. Conclusions: This rapid review highlights the growing relevance of ethical and equity considerations in the design and delivery of telerehabilitation within physiotherapy and occupational therapy. The findings show inconsistent reporting and limited depth in addressing key domains such as patient autonomy, privacy, and adverse events, alongside disparities related to age, gender, socioeconomic status, and geographic access. Although telerehabilitation holds promise for expanding access, particularly in underserved areas, this potential remains unevenly realized. The review underscores the critical need for structured, equity-driven, and ethically grounded frameworks such as the Metaverse Equitable Rehabilitation THerapy (MERTH) framework to guide future implementation, research, and policy. Full article

Background: Sexual assault victims involving penetration are at risk of contracting human immunodeficiency virus (HIV). Post-exposure prophylaxis (PEP) can effectively prevent HIV infection if initiated promptly within 72 h following exposure and adhered to for 28 days. Nonetheless, therapeutic adherence amongst sexual assault victims is low. Victim-centered care, provided by specially trained forensic nurses and midwives, may increase adherence. Methods: We conducted a retrospective case–control study to evaluate the impact of sexual assault center (SAC)—centered care on adherence to PEP compared to care received in the emergency department (ED). Data from January 2011 to February 2022 were reviewed. Multivariable logistic regression analysis was employed to determine the association between centralized specific care for sexual assault victims and completion of the 28-day PEP regimen. The secondary outcome assessed was provision of psychological support within 5 days following the assault. Results: We analyzed 856 patients of whom 403 (47.1%) received care at a specialized center for sexual assault victims. Attendance at the SAC, relative to the ED, was not associated with greater probability of PEP completion both in the unadjusted (52% vs. 50.6%; odds ratio [OR]: 1.06, 95% CI: 0.81 to 1.39; p = 0.666) and adjusted (OR: 0.81, 95%CI 0.58–1.11; p = 0.193) analysis. The care provided at the SAC was associated with improved early (42.7% vs. 21.5%; p < 0.001) and delayed (67.3% vs. 33.7%; p < 0.001) psychological support. Conclusions: SAC-centered care is not associated with an increase in PEP completion rates in sexual assault victims beyond the increase associated with improved access to early and delayed psychological support. Other measures to improve PEP completion rates should be developed. What is already known on this topic—Completion rates for HIV post-exposure prophylaxis (PEP) among victims of sexual assault are low. Specialized sexual assault centers, which provide comprehensive care and are distinct from emergency departments, have been suggested as a potential means of improving treatment adherence and completion rates. However, their actual impact on treatment completion remains unclear. What this study adds—This study found that HIV PEP completion rates in sexual assault victims were not significantly improved by centralized care in a specialized sexual assault center when compared to care initiated in the emergency department and continued within a sexually transmitted infection clinic. However, linkage to urgent psychological and psychiatric care was better in the specialized sexual assault center. How this study might affect research, practice or policy—Healthcare providers in sexual assault centers should be more aware of their critical role in promoting PEP adherence and improving completion rates. Policymakers should ensure that measures aimed at improving HIV PEP outcomes are implemented at all points of patient contact in these centers. Further research is needed to assess the cost-effectiveness of specialized sexual assault centers. Full article

Background/Objectives: The prevalence of people with incurable and progressive diseases in primary health care is high. Family doctors and nurses must be active agents in the early identification of palliative needs and the implementation of palliative approaches in cases of low to intermediate complexity. While there is a need for early referral of more complex palliative care (PC) cases to specialized teams, primary health care (PHC) professionals lack the confidence or skill to describe their role. This study sought to explore and describe (a) the practices of PHC professionals regarding their PC provision; (b) the barriers regarding access and referral of patients to specialized PC services; and (c) the strategies used or recommended to mitigate difficulties in accessing and referring to specialized PC. Methods: A descriptive qualitative study was carried out, using five focus groups conducted with nursing and medical staff at three local health units in the central region of Portugal. Semi-structured interviews were conducted, and then recorded, transcribed, and analyzed through a thematic analysis approach. The reporting of this research follows the COREQ checklist. Results: In total, 34 PHC professionals participated in this study. The majority of participants were women (n = 26) and family doctors (n = 24). Their mean age was 43.8 ± 11.9 (range: 29 to 65 years). The findings were organized into three core themes: (1) the contours of palliative action developed by PHC teams; (2) barriers to access and safe transition between PHC and specialized PC; and (3) ways to mitigate difficulties in accessing and referring to specialized PC. Conclusions: Our findings highlight the fundamental role of PHC professionals in providing primary PC, and in identifying PC needs and referring patients to PC early on, while exposing the systemic and interpersonal challenges that hinder these processes. To overcome these challenges, it is essential to invest in the development of integrated care models that promote practical, low-bureaucratic referral processes and capture the human resources necessary for the adequate follow-up of users. Full article

How to best support people living with dementia and their care partners living in the community to maximize their quality of life and quality of living through appropriate and effective non-pharmaceutical approaches remains a focus of dementia societies and organizations worldwide. This paper examines the views of a range of stakeholders about the potential of green care farms in Canada, a country new to the concept of the green care farm approach to dementia support and care. Data were collected in Southern Ontario, Canada, between June and August 2022 via an online questionnaire (n = 12) and 1-1 interviews (n = 6). Questionnaire data were analyzed using descriptive statistics, specifically counts and frequencies. All interviews were audio-recorded and fully transcribed verbatim and analyzed thematically. We report thematic findings relating to the understanding of care farms for people living with dementia, perceived benefits of care farming, perceived enablers and barriers to implementing such an approach, and the hopes, motivations, and expectations of different stakeholders. The potential of green care farming for people living with dementia and their care partners in the Canadian context was evident. There are implications for care policy and practice relating to the promotion of (social) health and wellbeing for people living with dementia. Full article

Background/Objectives: Persistent pulmonary hypertension of the newborn (PPHN) is characterized by increased pulmonary vascular resistance, resulting in severe hypoxemia. This study determined the factors associated with increased risk of mortality and survival rate in infants with PPHN. Methods: This retrospective study was conducted between 2010 and 2023. The risk factors for mortality were assessed by Cox’s proportional hazard models, and the Kaplan–Meier survival curve was used to analyze the survival rates. Results: This study included 233 neonates with PPHN. Gestational age (GA) less than 28 weeks (adjusted hazard ratio [AHR] = 5.46, 95% confidence interval [CI]: 2.25–13.24, p < 0.001), Small for gestational age (SGA) (AHR = 2.93, 95% confidence interval [CI]: 1.24–6.92, p = 0.026), acute kidney injury (AKI) (AHR = 2.48, 95% CI: 1.27–4.84, p = 0.01), pneumothorax (AHR = 3.03, 95% confidence interval [CI]: 1.48–6.21, p = 0.003), vasoactive-inotropic score (VIS) at 24 h of age (AHR = 1.0026, 95% confidence interval [CI]: 1.0004–1.005, p = 0.026), and score for neonatal acute physiology II (SNAP-II) ≥ 43 (AHR = 4.03, 95% CI: 1.66–9.77, p = 0.005) were associated with an increased risk of mortality. The overall survival rate was 82.4%; it rose from 63.8% to 87.1% after inhaled nitric oxide (iNO) and extracorporeal membrane oxygenation (ECMO) were introduced (p < 0.001). The cumulative survival rates at the end of the 30 days were 62.1% (95% CI: 49.0–78.7) in the Pre-iNO era and 87.5% (95% CI: 82.7–92.6) in the Post-iNO/ECMO era, respectively (p < 0.001). Conclusions: GA less than 28 weeks, SGA, AKI, pneumothorax, high VIS and SNAP-II scores were associated with mortality in infants with PPHN. The improvement in the survival rate was related to the provision of advanced care, including iNO and ECMO therapy. Full article