Extracorporeal membrane oxygenation in the treatment of neonatal refractory respiratory failure: experience of a single center in Southwest China
10.3760/cma.j.issn.2096-2932.2022.06.009
- VernacularTitle:西南地区单中心体外膜肺氧合技术治疗新生儿难治性呼吸衰竭的回顾性研究
- Author:
Jun WANG
1
;
Guang YUE
;
Yiyong FU
;
Wen ZENG
;
Ling ZHU
;
Xiaolong ZHANG
;
Xiaohong LUO
;
Rong JU
Author Information
1. 电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院新生儿科，成都 611731
- Keywords:
Extracorporeal membrane oxygenation;
Respiratory insufficiency;
Infant,newborn
- From:Chinese Journal of Neonatology
2022;37(6):525-529
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical experience of extracorporeal membrane oxygenation (ECMO) for neonatal refractory respiratory failure in a single medical center of Southwest China.Methods:From June 2020 to November 2021, the clinical data of neonates with refractory respiratory failure who received ECMO in the neonatal department of our hospital were retrospectively reviewed. The neonates were assigned into the survival group and the deceased group.Their general profile, clinical diagnosis, laboratory tests, ECMO operation, complications and prognosis were compared.Results:Eight neonates were included with five successfully withdrawal of ECMO and survived (5/8). For the three deceased neonates, two discontinued treatment because of intraventricular hemorrhage (grade Ⅲ~Ⅳ) and one confirmed congenital adrenal hyperplasia. No significant differences existed between the survival and the deceased groups in oxygenation index (OI), ECMO preparation and operation duration, usage of heparin, red blood cell suspension, platelet and sedative/analgesic drugs, therapeutic hypothermia and ECMO-associated complications. However, the deceased group had high OI values ( P=0.001), low lactate clearance ( P=0.005), more urine output during the first 24 h after ECMO ( P=0.046) and more fresh frozen plasma usage ( P=0.038). None of the five surviving children had significant developmental delay and neurological abnormalities during the 1-year follow-up. Conclusions:ECMO is effective treating neonatal refractory respiratory failure. Reducing the risk of intraventricular hemorrhage during ECMO may improve the survival rate.
