Abstract
Purpose Controversy exists regarding the criteria for placement of infants on extracorporeal membrane oxygenation (ECMO) at low birth weights. The authors hypothesized that ECMO is effective and safe in babies under 2 kg and sought to examine outcome and survival rate in these infants. Methods All patients less than 30 days old in the Extracorporeal Life Support Organization (ELSO) registry (n = 14,305) were divided into those less than 2 kg (n = 663) and more than 2 kg (n = 13,642). Multiple regression analysis determined factors that predicted survival rate and the lowest safe weight for ECMO. Results Overall survival rate was 76% and was lower in infants less than 2 kg (≥2 kg, 77% v <2 kg, 53%, P < .0001). Survival rate was significantly lower for patients with diaphragmatic hernia (CDH), bleeding, and intracranial hemorrhage (ICH) by regression. The incidence of ICH in babies less than 2.0 kg was 6% versus 4% in those more than 2.0 kg (P < .05). Regression analysis determined that the lowest weight at which a survival rate of 40% could be achieved was 1.6 kg. Conclusions Cannulation for ECMO may be safe and effective in babies under 2.0 kg and potentially as low as 1.6 kg. Judicious anticoagulation might limit bleeding, which occurred in a minority of these patients.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 845-847 |
| Number of pages | 3 |
| Journal | Journal of Pediatric Surgery |
| Volume | 39 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 1 2004 |
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Keywords
- congenital diaphragmatic hernia
- Extracorporeal membrane oxygenation
- prematurity
- respiratory failure
ASJC Scopus subject areas
- Surgery
- Pediatrics, Perinatology, and Child Health
Cite this
How low can you go? Effectiveness and safety of extracorporeal membrane oxygenation in low-birth-weight neonates. / Rozmiarek, Andrew J.; Qureshi, Faisal G.; Cassidy, Laura; Ford, Henri R.; Gaines, Barbara A.; Rycus, Peter; Hackam, David J.
In: Journal of Pediatric Surgery, Vol. 39, No. 6, 01.06.2004, p. 845-847.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - How low can you go? Effectiveness and safety of extracorporeal membrane oxygenation in low-birth-weight neonates
AU - Rozmiarek, Andrew J.
AU - Qureshi, Faisal G.
AU - Cassidy, Laura
AU - Ford, Henri R.
AU - Gaines, Barbara A.
AU - Rycus, Peter
AU - Hackam, David J.
PY - 2004/6/1
Y1 - 2004/6/1
N2 - Purpose Controversy exists regarding the criteria for placement of infants on extracorporeal membrane oxygenation (ECMO) at low birth weights. The authors hypothesized that ECMO is effective and safe in babies under 2 kg and sought to examine outcome and survival rate in these infants. Methods All patients less than 30 days old in the Extracorporeal Life Support Organization (ELSO) registry (n = 14,305) were divided into those less than 2 kg (n = 663) and more than 2 kg (n = 13,642). Multiple regression analysis determined factors that predicted survival rate and the lowest safe weight for ECMO. Results Overall survival rate was 76% and was lower in infants less than 2 kg (≥2 kg, 77% v <2 kg, 53%, P < .0001). Survival rate was significantly lower for patients with diaphragmatic hernia (CDH), bleeding, and intracranial hemorrhage (ICH) by regression. The incidence of ICH in babies less than 2.0 kg was 6% versus 4% in those more than 2.0 kg (P < .05). Regression analysis determined that the lowest weight at which a survival rate of 40% could be achieved was 1.6 kg. Conclusions Cannulation for ECMO may be safe and effective in babies under 2.0 kg and potentially as low as 1.6 kg. Judicious anticoagulation might limit bleeding, which occurred in a minority of these patients.
AB - Purpose Controversy exists regarding the criteria for placement of infants on extracorporeal membrane oxygenation (ECMO) at low birth weights. The authors hypothesized that ECMO is effective and safe in babies under 2 kg and sought to examine outcome and survival rate in these infants. Methods All patients less than 30 days old in the Extracorporeal Life Support Organization (ELSO) registry (n = 14,305) were divided into those less than 2 kg (n = 663) and more than 2 kg (n = 13,642). Multiple regression analysis determined factors that predicted survival rate and the lowest safe weight for ECMO. Results Overall survival rate was 76% and was lower in infants less than 2 kg (≥2 kg, 77% v <2 kg, 53%, P < .0001). Survival rate was significantly lower for patients with diaphragmatic hernia (CDH), bleeding, and intracranial hemorrhage (ICH) by regression. The incidence of ICH in babies less than 2.0 kg was 6% versus 4% in those more than 2.0 kg (P < .05). Regression analysis determined that the lowest weight at which a survival rate of 40% could be achieved was 1.6 kg. Conclusions Cannulation for ECMO may be safe and effective in babies under 2.0 kg and potentially as low as 1.6 kg. Judicious anticoagulation might limit bleeding, which occurred in a minority of these patients.
KW - congenital diaphragmatic hernia
KW - Extracorporeal membrane oxygenation
KW - prematurity
KW - respiratory failure
UR - http://www.scopus.com/inward/record.url?scp=3042579615&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=3042579615&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2004.02.012
DO - 10.1016/j.jpedsurg.2004.02.012
M3 - Article
C2 - 15185209
AN - SCOPUS:3042579615
VL - 39
SP - 845
EP - 847
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 6
ER -