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Pulmonary sequelae in infants treated with extracorporeal membrane oxygenation
J S Greenspan1, M J Antunes, W J Holt
1Department of Pediatrics, Thomas Jefferson Medical College and Hospital, Philadelphia, Pennsylvania, USA.
Pediatric Pulmonology
|January 1, 1997
Summary
Early extracorporeal membrane oxygenation (ECMO) in infants may lead to less long-term pulmonary dysfunction. Infants receiving ECMO earlier showed better airway function at discharge compared to those treated later.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Critical Care
Background:
- Extracorporeal membrane oxygenation (ECMO) decisions involve predicting infant morbidity and mortality.
- The impact of pre-ECMO pulmonary status on barotrauma and post-ECMO lung sequelae is not fully understood.
Purpose of the Study:
- To investigate if early ECMO initiation in neonates is associated with reduced subsequent pulmonary dysfunction compared to later initiation.
- To compare pulmonary function outcomes between early and late ECMO groups.
Main Methods:
- Evaluated pulmonary function (resistance, compliance, functional residual capacity, maximal expiratory flow) in 25 neonates before ECMO, post-ECMO, and at discharge.
- Assigned infants to an early ECMO group (<36 hours) or a late ECMO group (>36 hours).
Main Results:
- The early ECMO group had a higher initial oxygenation index but similar initial pulmonary function compared to the late group.
- Early ECMO infants showed significant improvements in compliance and resistance post-ECMO, which continued to improve by discharge.
- Maximal expiratory flow at discharge was significantly lower in the late ECMO group.
Conclusions:
- While both groups had minimal pulmonary dysfunction at discharge, early ECMO initiation was associated with slightly less airway dysfunction.
- Infants receiving ECMO earlier may experience better long-term pulmonary outcomes despite a higher initial need for support.