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Long-term pulmonary sequelae in children who were treated with extracorporeal membrane oxygenation for neonatal respiratory failure.
Pediatrics. 2004 Nov; 114(5):1292-6.Ped

Abstract

OBJECTIVE

Extracorporeal membrane oxygenation (ECMO) is a life-saving therapy for neonates with intractable respiratory failure, but the long-term pulmonary outcome is unknown. Our aim was to investigate the long-term pulmonary sequelae of these children.

STUDY DESIGN

We studied 50 children at 11.1 +/- 1.1 years (mean +/- SD) who had been treated with neonatal ECMO for meconium aspiration syndrome (38%), sepsis (18%), sepsis with pneumonia (12%), congenital diaphragmatic hernia (12%), congenital heart disease (8%), persistent pulmonary hypertension of the newborn (6%), and respiratory distress syndrome (4%) and 27 healthy controls (10.8 +/- 1.6 years). All subjects completed a respiratory questionnaire and performed pulmonary function and graded cardiopulmonary exercise testing.

RESULTS

Neonatal ECMO survivors had hyperinflation (median residual volume: 131%), airway obstruction (median forced expired volume in 1 second: 79%), lower oxygen saturation with exercise, and lower peak oxygen consumption than controls. The ECMO group achieved similar exercise minute ventilation to controls, with more rapid and shallow breathing. ECMO survivors had an increased frequency of exercise-induced bronchospasm. Those who required higher inspired oxygen tension and ventilator pressures after weaning from ECMO had lower forced expired volume in 1 second and oxygen saturation values.

CONCLUSION

Neonatal ECMO survivors experience lung injury lasting into later childhood. Lung dysfunction correlates with the extent and duration of barotrauma and oxygen exposure as neonates.

Authors+Show Affiliations

Division of Pediatric Pulmonology, Childrens Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA 90027, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15520110

Citation

Hamutcu, Refika, et al. "Long-term Pulmonary Sequelae in Children Who Were Treated With Extracorporeal Membrane Oxygenation for Neonatal Respiratory Failure." Pediatrics, vol. 114, no. 5, 2004, pp. 1292-6.
Hamutcu R, Nield TA, Garg M, et al. Long-term pulmonary sequelae in children who were treated with extracorporeal membrane oxygenation for neonatal respiratory failure. Pediatrics. 2004;114(5):1292-6.
Hamutcu, R., Nield, T. A., Garg, M., Keens, T. G., & Platzker, A. C. (2004). Long-term pulmonary sequelae in children who were treated with extracorporeal membrane oxygenation for neonatal respiratory failure. Pediatrics, 114(5), 1292-6.
Hamutcu R, et al. Long-term Pulmonary Sequelae in Children Who Were Treated With Extracorporeal Membrane Oxygenation for Neonatal Respiratory Failure. Pediatrics. 2004;114(5):1292-6. PubMed PMID: 15520110.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term pulmonary sequelae in children who were treated with extracorporeal membrane oxygenation for neonatal respiratory failure. AU - Hamutcu,Refika, AU - Nield,Toni A, AU - Garg,Meena, AU - Keens,Thomas G, AU - Platzker,Arnold C G, PY - 2004/11/3/pubmed PY - 2005/3/11/medline PY - 2004/11/3/entrez SP - 1292 EP - 6 JF - Pediatrics JO - Pediatrics VL - 114 IS - 5 N2 - OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) is a life-saving therapy for neonates with intractable respiratory failure, but the long-term pulmonary outcome is unknown. Our aim was to investigate the long-term pulmonary sequelae of these children. STUDY DESIGN: We studied 50 children at 11.1 +/- 1.1 years (mean +/- SD) who had been treated with neonatal ECMO for meconium aspiration syndrome (38%), sepsis (18%), sepsis with pneumonia (12%), congenital diaphragmatic hernia (12%), congenital heart disease (8%), persistent pulmonary hypertension of the newborn (6%), and respiratory distress syndrome (4%) and 27 healthy controls (10.8 +/- 1.6 years). All subjects completed a respiratory questionnaire and performed pulmonary function and graded cardiopulmonary exercise testing. RESULTS: Neonatal ECMO survivors had hyperinflation (median residual volume: 131%), airway obstruction (median forced expired volume in 1 second: 79%), lower oxygen saturation with exercise, and lower peak oxygen consumption than controls. The ECMO group achieved similar exercise minute ventilation to controls, with more rapid and shallow breathing. ECMO survivors had an increased frequency of exercise-induced bronchospasm. Those who required higher inspired oxygen tension and ventilator pressures after weaning from ECMO had lower forced expired volume in 1 second and oxygen saturation values. CONCLUSION: Neonatal ECMO survivors experience lung injury lasting into later childhood. Lung dysfunction correlates with the extent and duration of barotrauma and oxygen exposure as neonates. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/15520110/Long_term_pulmonary_sequelae_in_children_who_were_treated_with_extracorporeal_membrane_oxygenation_for_neonatal_respiratory_failure_ DB - PRIME DP - Unbound Medicine ER -