Venovenous versus venoarterial extracorporeal membrane oxygenation among infants with hypoxic-ischemic encephalopathy: is there a difference in outcome?
J Perinatol
; 41(8): 1916-1923, 2021 08.
Article
in En
| MEDLINE
| ID: mdl-34012056
ABSTRACT
OBJECTIVE:
Our hypothesis was that among infants with hypoxic-ischemic encephalopathy (HIE), venoarterial (VA), compared to venovenous (VV), extracorporeal membrane oxygenation (ECMO) is associated with an increased risk of mortality or intracranial hemorrhage (ICH). DESIGN/METHODS:
Retrospective cohort analysis of infants in the Children's Hospitals Neonatal Database from 2010 to 2016 with moderate or severe HIE, gestational age ≥36 weeks, and ECMO initiation <7 days of age. The primary outcome was mortality or ICH.RESULTS:
Severe HIE was more common in the VA ECMO group (n = 57), compared to the VV ECMO group (n = 53) (47.4% vs. 26.4%, P = 0.02). VA ECMO was associated with a significantly higher risk of death or ICH [57.9% vs. 34.0%, aOR 2.39 (1.08-5.28)] and mortality [31.6% vs. 11.3%, aOR 3.06 (1.08-8.68)], after adjusting for HIE severity.CONCLUSIONS:
In HIE, VA ECMO was associated with a higher incidence of mortality or ICH. VV ECMO may be beneficial in this population.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Extracorporeal Membrane Oxygenation
/
Hypoxia-Ischemia, Brain
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Child
/
Humans
/
Infant
/
Newborn
Language:
En
Journal:
J Perinatol
Journal subject:
PERINATOLOGIA
Year:
2021
Document type:
Article
Affiliation country:
Estados Unidos