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Extracorporeal membrane oxygenation in 61 neonates : Single-center experience

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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)

Submitter: 水上 尚典

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