Abstract
Background/purpose Restrictions for ECMO in neonates include birth weight less than 2 kg (BW < 2 kg) and/or gestational age less than 34 weeks (GA < 34 weeks). We sought to describe their relationship on mortality. Methods Neonates with a primary diagnosis code of CDH were identified in the Extracorporeal Life Support Organization (ELSO) registry, and logistic regression models were used to examine the effect of BW < 2 kg and GA < 34 weeks on mortality. Results We identified 7564 neonates with CDH. The overall mortality was 50%. There was a significantly higher risk of death with unadjusted odds ratio (OR) 2.39 (95% confidence interval [CI]: 1.53–3.74; P < 0.01) for BW < 2 kg neonates. The adjusted OR of death for BW < 2 kg neonates remained significantly high with over two-fold increase in the odds of mortality when adjusted for potential confounding variables (OR 2.11, 95% CI: 1.30–3.43; P < 0.01). However, no difference in mortality was observed in neonates with GA < 34 weeks. Conclusions While mortality among CDH neonates with a BW < 2 kg was substantially increased, GA < 34 weeks was not significantly associated with mortality. Effort should be made to identify the best candidates for ECMO in this high-risk group and develop treatment strategies to optimize their survival. Type of study Case–Control Study, Retrospective Comparative Study. Level of evidence Level III.
| Original language | English |
|---|---|
| Pages (from-to) | 2018-2025 |
| Number of pages | 8 |
| Journal | Journal of Pediatric Surgery |
| Volume | 52 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 1 2017 |
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Keywords
- CDH
- ECMO
- Low birthweight
- Low gestation
ASJC Scopus subject areas
- Surgery
- Pediatrics, Perinatology, and Child Health
Cite this
Cannulating the contraindicated : effect of low birth weight on mortality in neonates with congenital diaphragmatic hernia on extracorporeal membrane oxygenation. / Delaplain, Patrick T.; Zhang, Lishi; Chen, Yanjun; Nguyen, Danh V.; Di Nardo, Matteo; Cleary, John Patrick; Yu, Peter T.; Guner, Yigit S.
In: Journal of Pediatric Surgery, Vol. 52, No. 12, 01.12.2017, p. 2018-2025.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cannulating the contraindicated
T2 - effect of low birth weight on mortality in neonates with congenital diaphragmatic hernia on extracorporeal membrane oxygenation
AU - Delaplain, Patrick T.
AU - Zhang, Lishi
AU - Chen, Yanjun
AU - Nguyen, Danh V.
AU - Di Nardo, Matteo
AU - Cleary, John Patrick
AU - Yu, Peter T.
AU - Guner, Yigit S.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Background/purpose Restrictions for ECMO in neonates include birth weight less than 2 kg (BW < 2 kg) and/or gestational age less than 34 weeks (GA < 34 weeks). We sought to describe their relationship on mortality. Methods Neonates with a primary diagnosis code of CDH were identified in the Extracorporeal Life Support Organization (ELSO) registry, and logistic regression models were used to examine the effect of BW < 2 kg and GA < 34 weeks on mortality. Results We identified 7564 neonates with CDH. The overall mortality was 50%. There was a significantly higher risk of death with unadjusted odds ratio (OR) 2.39 (95% confidence interval [CI]: 1.53–3.74; P < 0.01) for BW < 2 kg neonates. The adjusted OR of death for BW < 2 kg neonates remained significantly high with over two-fold increase in the odds of mortality when adjusted for potential confounding variables (OR 2.11, 95% CI: 1.30–3.43; P < 0.01). However, no difference in mortality was observed in neonates with GA < 34 weeks. Conclusions While mortality among CDH neonates with a BW < 2 kg was substantially increased, GA < 34 weeks was not significantly associated with mortality. Effort should be made to identify the best candidates for ECMO in this high-risk group and develop treatment strategies to optimize their survival. Type of study Case–Control Study, Retrospective Comparative Study. Level of evidence Level III.
AB - Background/purpose Restrictions for ECMO in neonates include birth weight less than 2 kg (BW < 2 kg) and/or gestational age less than 34 weeks (GA < 34 weeks). We sought to describe their relationship on mortality. Methods Neonates with a primary diagnosis code of CDH were identified in the Extracorporeal Life Support Organization (ELSO) registry, and logistic regression models were used to examine the effect of BW < 2 kg and GA < 34 weeks on mortality. Results We identified 7564 neonates with CDH. The overall mortality was 50%. There was a significantly higher risk of death with unadjusted odds ratio (OR) 2.39 (95% confidence interval [CI]: 1.53–3.74; P < 0.01) for BW < 2 kg neonates. The adjusted OR of death for BW < 2 kg neonates remained significantly high with over two-fold increase in the odds of mortality when adjusted for potential confounding variables (OR 2.11, 95% CI: 1.30–3.43; P < 0.01). However, no difference in mortality was observed in neonates with GA < 34 weeks. Conclusions While mortality among CDH neonates with a BW < 2 kg was substantially increased, GA < 34 weeks was not significantly associated with mortality. Effort should be made to identify the best candidates for ECMO in this high-risk group and develop treatment strategies to optimize their survival. Type of study Case–Control Study, Retrospective Comparative Study. Level of evidence Level III.
KW - CDH
KW - ECMO
KW - Low birthweight
KW - Low gestation
UR - http://www.scopus.com/inward/record.url?scp=85029650706&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85029650706&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2017.08.037
DO - 10.1016/j.jpedsurg.2017.08.037
M3 - Article
AN - SCOPUS:85029650706
VL - 52
SP - 2018
EP - 2025
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 12
ER -