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Lookup NU author(s): Dr Kirsty Tanner, Dr Jon Smith
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Objective: To identify predictors of outcome in ex-premature infants supported with extracorporeal membrane oxygenation (ECMO) for acute hypoxic respiratory failure. Methods: Retrospective review of ex-premature infants with acquired acute hypoxic respiratory failure requiring ECMO support in the United Kingdom from 1992 to 2001. Review of follow up questionnaires completed by general practitioners and local paediatricians. Results: Sixty four ex-premature infants (5-10 each year) received ECMO support, despite increased use of advanced conventional treatments over the decade. The most common infective agent was respiratory syncytial virus (85% of cases). Median birth gestation was 29 weeks and median corrected age at the time of ECMO support was 42 weeks. Median ECMO support duration was relatively long, at 229 hours.. Survival to hospital discharge and to 6 months was 80%, remaining similar throughout the period of review. At follow up, 60% had long term neurodisability and 79% had chronic pulmonary problems. Of pre-ECMO factors, baseline oxygen dependence, younger age, and inpatient status were associated with, non-survival (pless than or equal to0.05). Of ECMO related factors, patient complications were independently associated with adverse neurodevelopmental outcome and death (p<0.01). Conclusions: Survival rates for ex-premature infants after ECMO support are favourable, but patients suffer a high burden of morbidity during intensive care and over the long term. At the time of ECMO referral, baseline oxygen dependence is the most important predictor of death, but no combination of the factors considered was associated with a mortality that would preclude ECMO support.
Author(s): Brown KL, Walker G, Grant DJ, Tanner K, Ridout DA, Shekerdemian LS, Smith JH, Davis C, Firmin RK, Goldman AP
Publication type: Article
Publication status: Published
Journal: Archives of Disease in Childhood - Fetal and Neonatal Edition
Year: 2004
Volume: 89
Issue: 5
Pages: F423-F427
ISSN (print): 1359-2998
ISSN (electronic): 1468-2052
Publisher: BMJ Publishing Group
URL: http://dx.doi.org/10.1136/adc.2003.033308
DOI: 10.1136/adc.2003.033308
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