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[The treatment of severe pulmonary hypertension in newborn infants using extracorporeal membrane oxygenation or conventional measures. An interinstitutional comparison].
Monatsschr Kinderheilkd. 1991 Oct; 139(10):681-6.MK

Abstract

In a two years retrospective study we analyzed neonates from a US and a German neonatal center with pulmonary hypertension (persistent fetal circulation--PFC). The US patients were treated with Extracorporeal Membrane Oxygenation (ECMO) the german patients with conventional methods as hyperventilation, catecholamines, and vasodilators. Both groups fulfilled the classical ECMO entrance criteria: an alveolar-arterial oxygen difference greater than 610 mmHg and an oxygenation index (i.e. mean airway pressure x FiO2 x 100/paO2 of greater than 40 mmHg. We compared anamnestic and respiratory parameters with the t-test for independent groups or the chi-square test accordingly. With one patient in each group the mortality was not significantly different and the rate of meconium aspirations was the same. The APGAR score at 5 min was significantly lower in the US group, prenatal care was undertaken in significantly less US than german patients. Time intervals between delivery and important therapeutic interventions as intubation, hyperventilation, first catecholamines were not significantly different between both groups. Also worst paO2, pH, and paCO2 were not significantly different. Mechanical ventilation was more aggressive in the US group, i.e. higher intermittent-mandatory-ventilation-rate and peak inspiratory pressure. On the one hand our studies demonstrate that even patients fulfilling ECMO criteria still have a good chance with conventional treatment. On the other hand differences in APGAR scores and prenatal care might indicate that hypoxic-ischemic influences alter the US-group morbidity.

Authors+Show Affiliations

Möller JC
Klinik für Pädiatrie, Medizinischen Universität Lübeck.
Jonas S
No affiliation info available
Sussmane JB
No affiliation info available
Tegtmeyer FK
No affiliation info available
Vardag AM
No affiliation info available
Richter A
No affiliation info available

MeSH

Apgar ScoreCatecholaminesExtracorporeal Membrane OxygenationHumansHypertension, PulmonaryInfant, NewbornPersistent Fetal Circulation SyndromePositive-Pressure RespirationPrenatal CareRetrospective StudiesVasodilator Agents

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

ger

PubMed ID

1961206

Citation

Möller, J C., et al. "[The Treatment of Severe Pulmonary Hypertension in Newborn Infants Using Extracorporeal Membrane Oxygenation or Conventional Measures. an Interinstitutional Comparison]." Monatsschrift Kinderheilkunde : Organ Der Deutschen Gesellschaft Fur Kinderheilkunde, vol. 139, no. 10, 1991, pp. 681-6.
Möller JC, Jonas S, Sussmane JB, et al. [The treatment of severe pulmonary hypertension in newborn infants using extracorporeal membrane oxygenation or conventional measures. An interinstitutional comparison]. Monatsschr Kinderheilkd. 1991;139(10):681-6.
Möller, J. C., Jonas, S., Sussmane, J. B., Tegtmeyer, F. K., Vardag, A. M., & Richter, A. (1991). [The treatment of severe pulmonary hypertension in newborn infants using extracorporeal membrane oxygenation or conventional measures. An interinstitutional comparison]. Monatsschrift Kinderheilkunde : Organ Der Deutschen Gesellschaft Fur Kinderheilkunde, 139(10), 681-6.
Möller JC, et al. [The Treatment of Severe Pulmonary Hypertension in Newborn Infants Using Extracorporeal Membrane Oxygenation or Conventional Measures. an Interinstitutional Comparison]. Monatsschr Kinderheilkd. 1991;139(10):681-6. PubMed PMID: 1961206.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [The treatment of severe pulmonary hypertension in newborn infants using extracorporeal membrane oxygenation or conventional measures. An interinstitutional comparison]. AU - Möller,J C, AU - Jonas,S, AU - Sussmane,J B, AU - Tegtmeyer,F K, AU - Vardag,A M, AU - Richter,A, PY - 1991/10/1/pubmed PY - 1991/10/1/medline PY - 1991/10/1/entrez SP - 681 EP - 6 JF - Monatsschrift Kinderheilkunde : Organ der Deutschen Gesellschaft fur Kinderheilkunde JO - Monatsschr Kinderheilkd VL - 139 IS - 10 N2 - In a two years retrospective study we analyzed neonates from a US and a German neonatal center with pulmonary hypertension (persistent fetal circulation--PFC). The US patients were treated with Extracorporeal Membrane Oxygenation (ECMO) the german patients with conventional methods as hyperventilation, catecholamines, and vasodilators. Both groups fulfilled the classical ECMO entrance criteria: an alveolar-arterial oxygen difference greater than 610 mmHg and an oxygenation index (i.e. mean airway pressure x FiO2 x 100/paO2 of greater than 40 mmHg. We compared anamnestic and respiratory parameters with the t-test for independent groups or the chi-square test accordingly. With one patient in each group the mortality was not significantly different and the rate of meconium aspirations was the same. The APGAR score at 5 min was significantly lower in the US group, prenatal care was undertaken in significantly less US than german patients. Time intervals between delivery and important therapeutic interventions as intubation, hyperventilation, first catecholamines were not significantly different between both groups. Also worst paO2, pH, and paCO2 were not significantly different. Mechanical ventilation was more aggressive in the US group, i.e. higher intermittent-mandatory-ventilation-rate and peak inspiratory pressure. On the one hand our studies demonstrate that even patients fulfilling ECMO criteria still have a good chance with conventional treatment. On the other hand differences in APGAR scores and prenatal care might indicate that hypoxic-ischemic influences alter the US-group morbidity. SN - 0026-9298 UR - https://www.unboundmedicine.com/medline/citation/1961206/[The_treatment_of_severe_pulmonary_hypertension_in_newborn_infants_using_extracorporeal_membrane_oxygenation_or_conventional_measures__An_interinstitutional_comparison]_ DB - PRIME DP - Unbound Medicine ER -