Document Detail


Neonatal extracorporeal life support: impact of new therapies on survival.
MedLine Citation:
PMID:  16737868     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the effects of pre-extracorporeal life support (ECLS) management with nitric oxide (NO), high frequency ventilation (HFV), and surfactant on mortality among neonates supported with ECLS. STUDY DESIGN: Extracorporeal Life Support Organization (ELSO) data on 7017 neonates cannulated for respiratory reasons between 1996 and 2003 were analyzed using chi2, analysis of variance, and logistic regression. RESULTS: The use of ECLS declined by 26.6% over the study period with no significant change in mortality. Unadjusted ECLS mortality for NO-treated patients was lower than for infants not treated with NO (25.1% vs 28.6%, P = .0012) and for infants treated with surfactant than for infants not treated with surfactant (18.7% vs 30.3%, p <.0001.) Unadjusted mortality for HFV-treated patients was no different than for non-HFV-treated patients (26.0% vs 26.6%, P = .56). After adjusting for confounders (primary diagnosis, age at cannulation, ECMO year 1996-1999 vs 2000-2003), surfactant use was associated with decreased mortality. NO-treated neonates were less likely to have a pre-ECLS cardiopulmonary arrest than infants not treated with NO. NO, HFV, and surfactant were not associated with prolongation of ECLS or mechanical ventilation. CONCLUSIONS: NO, HFV, and surfactant were not associated with increased mortality in neonates who require ECLS for hypoxic respiratory failure.
Authors:
Paola J Fliman; Raye-Ann O deRegnier; John P Kinsella; Marleta Reynolds; Linda L Rankin; Robin H Steinhorn
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  148     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-06-01     Completed Date:  2006-06-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  595-9     Citation Subset:  AIM; IM    
Affiliation:
Division of Neonatology, Northwestern University, Chicago, Illinois, USA. p-fliman@northwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Bronchodilator Agents / therapeutic use
Extracorporeal Membrane Oxygenation*
High-Frequency Ventilation
Humans
Infant
Infant, Newborn
Nitric Oxide / therapeutic use
Pulmonary Surfactants / therapeutic use
Registries
Respiratory Insufficiency / congenital,  mortality*,  therapy*
Retrospective Studies
Survival Rate
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 0/Pulmonary Surfactants; 10102-43-9/Nitric Oxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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