First 24-h SNAP-II score and highest PaCO2 predict the need for ECMO in congenital diaphragmatic hernia.
J Pediatr Surg
; 48(11): 2214-8, 2013 Nov.
Article
em En
| MEDLINE
| ID: mdl-24210188
ABSTRACT
BACKGROUND/PURPOSE:
Early clinical predictors for the use of ECMO in patients with congenital diaphragmatic hernia (CDH) are lacking. We sought to evaluate the first 24-h SNAP-II score and highest PaCO2 as predictors of ECMO support and in-hospital mortality in neonates with CDH.METHODS:
Retrospective review of 47 consecutive neonates with CDH admitted to our institution from January 2007 to December 2010 was performed. Covariates of ECMO use including SNAP-II score and highest PaCO2 within the first 24 h of NICU admission were evaluated.RESULTS:
Of the 47 infants in this study, 24 patients were supported with ECMO. The ECMO group had a higher incidence of pulmonary hypertension, higher PaCO2, and higher 24-h SNAP-II scores. Only the SNAP-II score and not highest PaCO2 predicted mortality following multivariate adjustment.CONCLUSIONS:
The first 24-h SNAP-II score and highest PaCO2 may provide some prognostic value in identifying neonates who undergo ECMO support; however neither measure was independently associated with the use of therapy. Only the SNAP-II score was associated with in-hospital mortality following multivariate adjustment. Additional study is needed to validate these results in a larger data set.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Índice de Gravidade de Doença
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Dióxido de Carbono
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Oxigenação por Membrana Extracorpórea
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Hérnias Diafragmáticas Congênitas
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article