The impact of changing neonatal respiratory management on extracorporeal membrane oxygenation utilization☆
Section snippets
Materials and methods
We retrospectively reviewed data collected on all ECMO neonates with non-CDH and noncardiac causes of respiratory failure between January 1, 1989 and January 1, 2001. Neonates were separated into 3 time periods for comparison (A, 1989 through 1992; B, 1993 through 1996; C, 1997 through 2000). Data chosen for comparison included total number of neonates placed on ECMO, mean gestational age, gender, birth weight, Apgar scores, age at transfer, age at initiation of ECMO, arterial blood gas levels,
Results
Between January 1, 1989 and January 1, 2001, 499 neonates with cardiopulmonary failure underwent ECMO in our institution. All neonates were transferred in from outside facilities. Three hundred forty-two neonates without CDH or cardiac causes of respiratory failure were treated with ECMO (Table 1).Gestational age, birth weight, Apgar scores, pre-ECMO pH level, pCO2 and oxygen index (OI) are outlined in Table 2.Pre-ECMO mean airway pressure, use of INO and HFV, age at which ECMO was initiated,
Discussion
The current study was undertaken to evaluate the changes in demographics and outcomes of neonates with noncardiac and non-CDH causes of respiratory failure requiring ECMO therapy over the past 12 years. During the study period, the number of ECMO centers in the vicinity and the total number of neonatal intensive care unit (NICU) admissions have remained unchanged. In our institution, all NICU admissions are transferred from outside facilities. Our results show that there has been a progressive
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High frequency jet ventilation for congenital diaphragmatic hernia
2023, Journal of Pediatric SurgeryExtracorporeal Membrane Oxygenation (ECMO) in Pediatric and Neonatal Patients
2008, Mechanical Ventilation: Clinical Applications and PathophysiologyNeonatal extracorporeal life support: Impact of new therapies on survival
2006, Journal of PediatricsThe diseases treated with ECMO: Focus on PPHN
2005, Seminars in PerinatologyWhat's new in pediatric surgery
2003, Journal of the American College of SurgeonsCurrent state of neonatal extracorporeal membrane oxygenation in Colombia: Description of the first cases
2014, Archivos de Cardiologia de Mexico
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Address reprint requests to J.E. Stein, MD, Children's Hospital of Los Angeles, 4650 Sunset Blvd, MS#72, Los Angeles, CA 90027.