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Risk Factors for Bronchopulmonary Dysplasia After Extracorporeal Membrane Oxygenation

Michael S. Kornhauser, MD; James A. Cullen, RN; Stephen Baumgart, MD; Linda J. McKee, MHS; George W. Gross, MD; Alan R. Spitzer, MD
Arch Pediatr Adolesc Med. 1994;148(8):820-825. doi:10.1001/archpedi.1994.02170080050008.
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Objective:  To determine risk factors for the development of bronchopulmonary dysplasia (BPD) after treatment with extracorporeal membrane oxygenation (ECMO).

Design:  Retrospective case-control study.

Setting:  Tertiary care level 3 neonatal intensive care unit.

Participants:  Seventy-three newborns treated with ECMO for severe respiratory failure during a 5-year period, who survived until day of life 28, and who did not have pulmonary hypoplasia as the initial cause for respiratory failure.

Interventions:  None.

Main Outcome Measure:  The presence of BPD after treatment with ECMO, which was defined as oxygen and/or ventilatory requirements at day of life 28, with characteristic abnormalities seen on chest x-ray film.

Results:  The age at ECMO initiation was significantly greater for patients with BPD compared with patients without BPD (mean±SD, 135±68 hours vs 50±37 hours; P<.001). There was an 11.5-fold increased risk for the development of BPD if ECMO was initiated at greater than 96 hours of age. The primary diagnosis of respiratory distress syndrome imparted a 5.2-fold increased risk for the development of BPD. Patients with BPD required ECMO significantly longer than patients without BPD (203±73 hours vs 122±51 hours; P<.001).

Conclusion:  These results demonstrate that delayed use of ECMO in treating neonatal respiratory failure is associated with an increased risk for the development of BPD and a longer duration of ECMO therapy.(Arch Pediatr Adolesc Med. 1994;148:820-825)


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