Related Experiment Videos
Pulmonary sequelae at six months following extracorporeal membrane oxygenation
M Garg1, S I Kurzner, D B Bautista
1Division of Neonatology and Pediatric Pulmonology, Childrens Hospital of Los Angeles, University of Southern California School of Medicine.
Insights
Extracorporeal membrane oxygenation (ECMO) survivors often show residual lung disease. Neonatal lung injury, not ECMO treatment, may be the primary cause of these long-term pulmonary issues.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Critical Care Medicine
Background:
- Mechanical ventilation for neonatal respiratory failure can lead to chronic lung disease.
- Extracorporeal membrane oxygenation (ECMO) rests the lungs, prompting investigation into its potential to prevent chronic lung disease in survivors.
Purpose of the Study:
- To assess pulmonary sequelae in infants treated with ECMO for neonatal respiratory failure.
- To compare pulmonary mechanics in ECMO survivors with those of preterm infants suffering from bronchopulmonary dysplasia (BPD).
Main Methods:
- Studied 19 infants treated with ECMO for neonatal respiratory failure.
- Assessed clinical lung disease, need for supplemental oxygen or pulmonary medications, and thoracic gas volume at six months of age.
- Compared pulmonary mechanics with 13 preterm infants with BPD.
Main Results:
- Ten out of 19 ECMO survivors required ongoing oxygen or pulmonary medications for clinical lung disease within the first six months.
- Thoracic gas volume was within normal limits in ECMO survivors.
- A significant proportion of ECMO survivors exhibited residual abnormalities in pulmonary mechanics at six months.
Conclusions:
- A substantial number of ECMO survivors experience persistent pulmonary abnormalities.
- Neonatal lung injury, potentially from meconium aspiration, appears to be a more significant factor in long-term pulmonary sequelae than the ECMO treatment itself.
Abstract:
Mechanical assisted ventilation for neonatal respiratory failure is associated with residual lung disease. Because ECMO rests the lungs, it has been suggested that ECMO will prevent chronic lung disease in survivors. To determine whether or not ECMO survivors have evidence of pulmonary sequelae, we studied 19 infants who were treated with ECMO for neonatal respiratory failure. Ten infants still required supplemental oxygen or pulmonary medications or both to treat clinical lung disease during the first six months of life. Thoracic gas volume was normal. Pulmonary mechanics in ECMO survivors were compared with those of 13 preterm infants with BPD at similar age. We conclude that a significant proportion of ECMO survivors have residual abnormalities in pulmonary mechanics at 6 months of age. We speculate that neonatal lung injury due to meconium aspiration and other causes is a more important determinant of abnormal pulmonary sequelae than the method of treatment.