Neonatal extracorporeal life support: Impact of new therapies on survival

Paola J. Fliman, Raye Ann O deRegnier, John P. Kinsella, Marleta Reynolds, Linda L. Rankin, Robin H Steinhorn

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Objective: To evaluate the effects of pre-extracorporeal life support (ECLS) management with nitric oxide (NO), high frequency ventilation (HFV), and surfactant on mortality among neonates supported with ECLS. Study design: Extracorporeal Life Support Organization (ELSO) data on 7017 neonates cannulated for respiratory reasons between 1996 and 2003 were analyzed using χ2, analysis of variance, and logistic regression. Results: The use of ECLS declined by 26.6% over the study period with no significant change in mortality. Unadjusted ECLS mortality for NO-treated patients was lower than for infants not treated with NO (25.1% vs 28.6%, P = .0012) and for infants treated with surfactant than for infants not treated with surfactant (18.7% vs 30.3%, p <.0001.) Unadjusted mortality for HFV-treated patients was no different than for non-HFV-treated patients (26.0% vs 26.6%, P = .56). After adjusting for confounders (primary diagnosis, age at cannulation, ECMO year 1996-1999 vs 2000-2003), surfactant use was associated with decreased mortality. NO-treated neonates were less likely to have a pre-ECLS cardiopulmonary arrest than infants not treated with NO. NO, HFV, and surfactant were not associated with prolongation of ECLS or mechanical ventilation. Conclusions: NO, HFV, and surfactant were not associated with increased mortality in neonates who require ECLS for hypoxic respiratory failure.

Original languageEnglish (US)
Pages (from-to)595-599
Number of pages5
JournalJournal of Pediatrics
Volume148
Issue number5
DOIs
StatePublished - May 2006
Externally publishedYes

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Extracorporeal Membrane Oxygenation
Surface-Active Agents
Nitric Oxide
High-Frequency Ventilation
Survival
Mortality
Newborn Infant
Therapeutics
Life Support Care
Heart Arrest
Artificial Respiration
Catheterization
Respiratory Insufficiency
Ventilation
Analysis of Variance
Logistic Models
Organizations

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Fliman, P. J., deRegnier, R. A. O., Kinsella, J. P., Reynolds, M., Rankin, L. L., & Steinhorn, R. H. (2006). Neonatal extracorporeal life support: Impact of new therapies on survival. Journal of Pediatrics, 148(5), 595-599. https://doi.org/10.1016/j.jpeds.2005.12.024

Neonatal extracorporeal life support : Impact of new therapies on survival. / Fliman, Paola J.; deRegnier, Raye Ann O; Kinsella, John P.; Reynolds, Marleta; Rankin, Linda L.; Steinhorn, Robin H.

In: Journal of Pediatrics, Vol. 148, No. 5, 05.2006, p. 595-599.

Research output: Contribution to journalArticle

Fliman, PJ, deRegnier, RAO, Kinsella, JP, Reynolds, M, Rankin, LL & Steinhorn, RH 2006, 'Neonatal extracorporeal life support: Impact of new therapies on survival', Journal of Pediatrics, vol. 148, no. 5, pp. 595-599. https://doi.org/10.1016/j.jpeds.2005.12.024
Fliman PJ, deRegnier RAO, Kinsella JP, Reynolds M, Rankin LL, Steinhorn RH. Neonatal extracorporeal life support: Impact of new therapies on survival. Journal of Pediatrics. 2006 May;148(5):595-599. https://doi.org/10.1016/j.jpeds.2005.12.024
Fliman, Paola J. ; deRegnier, Raye Ann O ; Kinsella, John P. ; Reynolds, Marleta ; Rankin, Linda L. ; Steinhorn, Robin H. / Neonatal extracorporeal life support : Impact of new therapies on survival. In: Journal of Pediatrics. 2006 ; Vol. 148, No. 5. pp. 595-599.
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