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Extracorporeal membrane oxygenation in 61 neonates : Single-center experience
| Title: | Extracorporeal membrane oxygenation in 61 neonates : Single-center experience |
| Other Titles: | ECMO in neonates |
| Authors: | Hirakawa, Eiji Browse this author | | Ibara, Satoshi Browse this author | | Tokuhisa, Takuya Browse this author | | Maede, Yoshinobu Browse this author | | Kuwahara, Takako Browse this author | | Ishihara, Chie Browse this author | | Noguchi, Hiroyuki Browse this author | | Naitou, Yoshiki Browse this author | | Yamamoto, Masakatsu Browse this author | | Kibe, Masaya Browse this author | | Yamamoto, Tsuyoshi Browse this author | | Kurimoto, Tomonori Browse this author | | Kamitomo, Masato Browse this author | | Cho, Kazutoshi Browse this author →KAKEN DB | | Minakami, Hisanori Browse this author →KAKEN DB |
| Keywords: | extracorporeal life support | | meconium aspiration syndrome | | neonatal complication | | respiratory depression | | respiratory failure |
| Issue Date: | Apr-2017 |
| Publisher: | Wiley |
| Journal Title: | Pediatrics international |
| Volume: | 59 |
| Issue: | 4 |
| Start Page: | 438 |
| End Page: | 442 |
| Publisher DOI: | 10.1111/ped.13178 |
| PMID: | 27696630 |
| Abstract: | Background: There have been few reports on the outcome of extracorporeal membrane oxygenation (ECMO) in newborn Japanese infants. Methods: A review was carried out of 61 neonates with ECMO between January 1995 and December 2015 at a single center. ECMO was used in neonates with oxygenation index >20 after conventional treatment. Background factors, such as etiology, vascular access mode (veno-venous [VV] or veno-arterial [VA]), number of days with ECMO, and early ECMO (within 24 h after birth), were analyzed in relation to outcome with respect to survival to hospital discharge (SHD). Results: Survival to hospital discharge was achieved in 35 infants (57%), while the remaining 26 died during hospital stay. Gestational age at birth was significantly higher and number of days with ECMO was significantly lower in SHD infants compared with those with adverse outcome (median, 4.0 vs 5.5 days, respectively; P = 0.008). The SHD rate was significantly higher for those with VV than VA vascular access mode (78%, 18/23 vs 45%, 17/38, respectively; P = 0.016), and for those with than without early ECMO (72%, 28/39 vs 32%, 7/22, respectively; P = 0.003). The SHD rate was relatively high in neonates with meconium aspiration syndrome (86%, 12/14), persistent pulmonary hypertension associated with hypoxic ischemic encephalopathy (75%, 6/8), and emphysema (80%, 4/5). On stepwise logistic regression analysis two independent factors of SHD were identified: early ECMO (OR, 9.63; 95%CI: 2.47-37.6) and ECMO length <8 days (OR, 8.05; 95%CI: 1.94-33.5). Conclusions: Neonates with early ECMO and those with ECMO duration <8 days may benefit from ECMO with respect to SHD. |
| Rights: | This is the peer reviewed version of the following article: Hirakawa, E., Ibara, S., Tokuhisa, T., Maede, Y., Kuwahara, T., Ishihara, C., Noguchi, H., Naitou, Y., Yamamoto, M., Kibe, M., Yamamoto, T., Kurimoto, T., Kamitomo, M., Cho, K. and Minakami, H. (2017), Extracorporeal membrane oxygenation in 61 neonates: Single-center experience. Pediatrics International, 59: 438–442, which has been published in final form at http://dx.doi.org/10.1111/ped.13178. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/68663 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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Submitter: 水上 尚典
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