Pao2 and Mortality in Neonatal Extracorporeal Membrane Oxygenation : Retrospective Analysis of the Extracorporeal Life Support Organization Registry, 2015-2020
Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies..
OBJECTIVES: Extracorporeal life support can lead to rapid reversal of hypoxemia but the benefits and harms of different oxygenation targets in severely ill patients are unclear. Our primary objective was to investigate the association between the Pao2 after extracorporeal membrane oxygenation (ECMO) initiation and mortality in neonates treated for respiratory failure.
DESIGN: Retrospective analysis of the Extracorporeal Life Support Organization (ELSO) Registry data, 2015-2020.
PATIENTS: Newborns supported by ECMO for respiratory indication were included.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Pao2 24 hours after ECMO initiation (H24 Pao2) was reported. The primary outcome was 28-day mortality. We identified 3533 newborns (median age 1 d [interquartile range (IQR), 1-3]; median weight 3.2 kg [IQR, 2.8-3.6]) from 198 ELSO centers, who were placed on ECMO. By 28 days of life, 731 (20.7%) had died. The median H24 Pao2 was 85 mm Hg (IQR, 60-142). We found that both hypoxia (Pao2 < 60 mm Hg) and moderate hyperoxia (Pao2 201-300 mm Hg) were associated with greater adjusted odds ratio (aOR [95% CI]) of 28-day mortality, respectively: aOR 1.44 (95% CI, 1.08-1.93), p = 0.016, and aOR 1.49 (95% CI, 1.01-2.19), p value equals to 0.045.
CONCLUSIONS: Early hypoxia or moderate hyperoxia after ECMO initiation are each associated with greater odds of 28-day mortality among neonates requiring ECMO for respiratory failure.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies - (2024) vom: 21. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Brohan, Orlane [VerfasserIn] |
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| Anmerkungen: |
Date Revised 21.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1097/PCC.0000000000003508 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370015711 |
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| 100 | 1 | |a Brohan, Orlane |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Pao2 and Mortality in Neonatal Extracorporeal Membrane Oxygenation |b Retrospective Analysis of the Extracorporeal Life Support Organization Registry, 2015-2020 |
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| 500 | |a Date Revised 21.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. | ||
| 520 | |a OBJECTIVES: Extracorporeal life support can lead to rapid reversal of hypoxemia but the benefits and harms of different oxygenation targets in severely ill patients are unclear. Our primary objective was to investigate the association between the Pao2 after extracorporeal membrane oxygenation (ECMO) initiation and mortality in neonates treated for respiratory failure | ||
| 520 | |a DESIGN: Retrospective analysis of the Extracorporeal Life Support Organization (ELSO) Registry data, 2015-2020 | ||
| 520 | |a PATIENTS: Newborns supported by ECMO for respiratory indication were included | ||
| 520 | |a INTERVENTIONS: None | ||
| 520 | |a MEASUREMENTS AND MAIN RESULTS: Pao2 24 hours after ECMO initiation (H24 Pao2) was reported. The primary outcome was 28-day mortality. We identified 3533 newborns (median age 1 d [interquartile range (IQR), 1-3]; median weight 3.2 kg [IQR, 2.8-3.6]) from 198 ELSO centers, who were placed on ECMO. By 28 days of life, 731 (20.7%) had died. The median H24 Pao2 was 85 mm Hg (IQR, 60-142). We found that both hypoxia (Pao2 < 60 mm Hg) and moderate hyperoxia (Pao2 201-300 mm Hg) were associated with greater adjusted odds ratio (aOR [95% CI]) of 28-day mortality, respectively: aOR 1.44 (95% CI, 1.08-1.93), p = 0.016, and aOR 1.49 (95% CI, 1.01-2.19), p value equals to 0.045 | ||
| 520 | |a CONCLUSIONS: Early hypoxia or moderate hyperoxia after ECMO initiation are each associated with greater odds of 28-day mortality among neonates requiring ECMO for respiratory failure | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Chenouard, Alexis |e verfasserin |4 aut | |
| 700 | 1 | |a Gaultier, Aurélie |e verfasserin |4 aut | |
| 700 | 1 | |a Tonna, Joseph E |e verfasserin |4 aut | |
| 700 | 1 | |a Rycus, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Pezzato, Stefano |e verfasserin |4 aut | |
| 700 | 1 | |a Moscatelli, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Liet, Jean-Michel |e verfasserin |4 aut | |
| 700 | 1 | |a Bourgoin, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Rozé, Jean-Christophe |e verfasserin |4 aut | |
| 700 | 1 | |a Léger, Pierre-Louis |e verfasserin |4 aut | |
| 700 | 1 | |a Rambaud, Jérôme |e verfasserin |4 aut | |
| 700 | 1 | |a Joram, Nicolas |e verfasserin |4 aut | |
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