RT Journal Article
SR Electronic
T1 Histological changes in the hearts of non-survivors of the UK Collaborative Trial of Neonatal ECMO (extra corporeal membrane oxygen)
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F30
OP F34
DO 10.1136/fn.81.1.F30
VO 81
IS 1
A1 Margaret J Evans
A1 J W Keeling
YR 1999
UL http://fn.bmj.com/content/81/1/F30.abstract
AB AIMS To study the cardiac pathology of infants enrolled in the UK collaborative trial of neonatal ECMO (extra corporeal membrane oxygen) who died following random allocation to a trial arm. METHODS During the trial, 81 infants died. The hearts of 26 babies were received and examined without knowledge of treatment regimen. The control group consisted of 14 infants who received conventional treatment. Twelve were allocated to ECMO; seven received this treatment. RESULTS In the control group, four showed minor histological changes. The other hearts were histologically normal. In the group treated with ECMO, four had multiple foci of micro-infarction throughout both ventricles and papillary muscles. There was variable thrombotic vascular occlusion. Three were normal. There was no correlation between cardiac pathology and clinical features. There was a significant difference in the length of survival between the two groups. CONCLUSIONS ECMO treatment seems to be associated with clinically significant cardiac pathology. The changes observed may reflect the longevity of survival in the ECMO group rather than an association with the treatment itself. Nevertheless, the findings have significant implications for those monitoring the development of infants surviving ECMO treatment and suggest that the monitoring of myocardial function will be crucial.