Predictors of intracranial hemorrhage during neonatal extracorporeal membrane oxygenation  

Oleh:

Hardart, George E. ; Fackler, James C.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Journal of Pediatrics vol. 135 no. 02 (Feb. 1999), page 156-159.
Topik: ECMO ; Extracorporeal membrane oxygenation; ELSO ; Extracorporeal Life Support Organization; ICH ; Intracranial hemorrhage; PaO2; Arterial oxygen tension; PaCO2; Arterial carbon dioxide tension

Ketersediaan

Perpustakaan FK Nomor Panggil: J45.K.1999.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Objective: To identify independent predictors of intracranial hemorrhage (ICH) during neonatal extracorporeal membrane oxygenation (ECMO). Study design: This retrospective cohort consisted of all neonates who did not have an ICH before treatment with ECMO identified in the Extracorporeal Life Support Organization Registry from 1992 to 1995 (n = 4550). Multiple logistic regression analysis was used to identify factors independently correlated with ICH and to develop a model that could be used to predict the risk of ICH in neonates treated with ECMO. Results: ICH was identified in 9.9% of patients. The factors associated with ICH remaining after adjusting for other significant variables (P < .01) were gestational age (GA) <34 weeks (odds ratio [OR] 12.1, 95% confidence intervals [CI] [6.6, 22]), GA 34 to <36 weeks (OR 4.1, CI [2.9, 5.8]), GA 36 to <38 weeks (OR 2.1, CI [1.6, 2.8]) primary diagnosis of sepsis (OR 1.8, CI [1.4, 2.3]), epinephrine use (OR 1.9, CI [1.5, 2.5]), coagulopathy (OR 1.6, CI [1.1, 2.2]), arterial pH <7.0 (OR 2.5, CI [1.6, 3.9]), and arterial pH 7.0 to <7.2 (OR 1.8 CI [1.3, 2.5]). ICH rates for neonates receiving venovenous versus venoarterial ECMO and for those treated with or without cephalic jugular venous drainage were not significantly different. Conclusions: Gestational age, acidosis, sepsis, coagulopathy, and treatment with epinephrine are major independent factors associated with ICH in neonates treated with ECMO. In particular, GA <34 weeks remains a major barrier for use of current ECMO technologies.

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