Faculty Collaboration Database

Echocardiographic prediction of neonatal ECMO outcome. Pediatr Cardiol 1997;18(4):270-5

Date

07/01/1997

Pubmed ID

9175523

DOI

10.1007/s002469900173

Scopus ID

2-s2.0-0031000257 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

Cardiopulmonary physiology was assessed by Doppler echocardiography in neonates undergoing pre-ECMO evaluation for meconium aspiration syndrome, congenital diaphragmatic hernia, persistent fetal circulation, and sepsis, from March 1987 through July 1992 (n = 136). Percent survival by diagnosis was: meconium aspiration syndrome, 86%; persistent fetal circulation, 68%; congenital diaphragmatic hernia, 63%; sepsis, 33%. Survival odds by diagnosis predicted a better outcome for meconium aspiration syndrome than for congenital diaphragmatic hernia and sepsis, and a better outcome for persistent fetal circulation than for sepsis. Percent survival for right-to-left patent ductus arteriosus flow (PDA) was 56%; other patent ductus arteriosus flow was 84%. In multivariate analysis, percent survival in congenital diaphragmatic hernia and persistent fetal circulation patients with right-to-left PDA flow suggested a worse outcome (% survival right-to-left vs other: congenital diaphragmatic hernia, 13% vs 70%; persistent fetal circulation, 25% vs 85%), whereas percent survival did not appear to suggest the same in meconium aspiration syndrome or sepsis patients. Similar analysis in non-ECMO patients suggested a worse outcome with right-to-left PDA flow in patients with meconium aspiration syndrome and congenital diaphragmatic hernia. Right-to-left PDA flow, sepsis, and congenital diaphragmatic hernia were associated with a poorer ECMO outcome. Initial assessment of PDA flow helps predict ECMO outcome.

Author List

Gotteiner NL, Harper WR, Gidding SS, Berdusis K, Wiley AM, Reynolds M, Benson DW Jr

MESH terms used to index this publication - Major topics in bold

Ductus Arteriosus, Patent
Echocardiography, Doppler
Extracorporeal Membrane Oxygenation
Heart Defects, Congenital
Heart Septal Defects, Atrial
Hernia, Diaphragmatic
Hernias, Diaphragmatic, Congenital
Humans
Infant, Newborn
Meconium Aspiration Syndrome
Persistent Fetal Circulation Syndrome
Predictive Value of Tests
Sepsis
Treatment Outcome