How low can you go? Effectiveness and safety of extracorporeal membrane oxygenation in low-birth-weight neonates

Andrew J. Rozmiarek, Faisal G. Qureshi, Laura Cassidy, Henri R. Ford, Barbara A. Gaines, Peter Rycus, David J. Hackam

Research output: Contribution to journalArticle

19 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)845-847
Number of pages3
JournalJournal of Pediatric Surgery
Volume39
Issue number6
DOIs
StatePublished - Jun 1 2004

Fingerprint

Extracorporeal Membrane Oxygenation
Low Birth Weight Infant
Survival Rate
Newborn Infant
Safety
Intracranial Hemorrhages
Regression Analysis
Hemorrhage
Weights and Measures
Diaphragmatic Hernia
Catheterization
Registries
Organizations
Incidence

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 journalArticle

Rozmiarek, Andrew J. ; Qureshi, Faisal G. ; Cassidy, Laura ; Ford, Henri R. ; Gaines, Barbara A. ; Rycus, Peter ; Hackam, David J. / How low can you go? Effectiveness and safety of extracorporeal membrane oxygenation in low-birth-weight neonates. In: Journal of Pediatric Surgery. 2004 ; Vol. 39, No. 6. pp. 845-847.
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