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Am J Perinatol 2017; 34(13): 1347-1353
DOI: 10.1055/s-0037-1603593
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

In-Hospital Outcomes Following Extracorporeal Membrane Oxygenation in a Retrospective Cohort of Infants

Maya Schueller
1   Duke University School of Medicine, Durham, North Carolina
,
Rachel G. Greenberg
2   Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
3   Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
,
P. Brian Smith
2   Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
3   Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
,
Matthew M. Laughon
4   Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Reese H. Clark
5   Pediatrix Medical Group, Inc., Sunrise, Florida
,
Christoph P. Hornik
2   Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
3   Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
› Author Affiliations
Further Information

Publication History

04 January 2017

25 April 2017

Publication Date:
25 May 2017 (online)

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Abstract

Objective We sought to characterize associations between infant characteristics and extracorporeal membrane oxygenation (ECMO) survival using electronic health records data.

Study Design We examined a cohort study of infants ≥32 weeks of gestational age and ≥1,800 g birth weight supported with ECMO in a Pediatrix Medical Group neonatal intensive care unit from 1998 to 2013.

Results We identified 268 infants, of which 45 (17%) were <37 weeks of gestational age. Survival to discharge was 87% but was lower in premature compared with term infants (76 vs. 89%, p = 0.03). In multivariable analysis, acute kidney injury (odds ratio [OR] = 4.00; 95% confidence interval [CI] = 1.05, 15.24), postnatal age at cannulation of 7 to 13 days (OR = 5.86; 95% CI = 1.21, 28.44), and venoarterial ECMO cannulation (OR = 4.33; 95% CI = 1.77, 10.60) were associated with lower survival.

Conclusion ECMO cannulation type, postnatal age, and acute kidney injury were associated with lower ECMO survival, while prematurity was not. Future studies are needed to identify risk factors and strategies to improve outcomes.

Keywords

extracorporeal membrane oxygenation - infant - survival - temporal trends
 

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