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Extracorporeal membrane oxygenation causing asymmetric vasculopathy in neonatal infants.

Publication ,  Journal Article
Young, TL; Quinn, GE; Baumgart, S; Petersen, RA; Schaffer, DB
Published in: J AAPOS
December 1997

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a form of cardiopulmonary bypass therapy used in term or near-term infants with severe cardiorespiratory disorders not responsive to conventional intensive care interventions. An ECMO-associated retinal vasculopathy has been described with little reference to the specific condition of the patient. We examined the eyes of 91 infants who underwent ECMO treatment. An assessment was made of the following: (1) when retinal changes occurred, (2) whether there was a particular systemic disorder or ECMO approach associated with these retinal findings, and (3) whether there may be ocular sequelae from this development. METHODS: Ninety-one neonates were treated with ECMO for meconium aspiration syndrome (MAS), primary persistent pulmonary hypertension of the newborn, sepsis, congenital diaphragmatic hernia (CDH), respiratory distress syndrome (RDS), and blood aspiration. Venoarterial bypass was performed in 73 patients. The remaining 18 patients underwent venovenous bypass. Ophthalmologic examinations were performed during bypass in 6 infants and within 3 weeks of ECMO in the remainder. RESULTS: Asymmetric retinopathy (left eye > right eye) was discovered in six infants with CDH and in one infant with RDS within a 2-week period after bypass, demonstrating venous tortuosity with or without intraretinal hemorrhages. One infant treated for MAS had a left eye intraretinal hemorrhage only. All patients with the noted retinal changes underwent venoarterial cannulation. Six of 9 patients with CDH had retinal findings noted compared with 1 of 10 patients with RDS and 1 of 35 patients with MAS. CONCLUSION: Because we were able to examine infants while they were receiving ECMO or shortly after termination of bypass, asymmetric vasculopathy was found in a greater percentage of our patients compared with a similar large case series. ECMO-associated retinal vasculopathy appeared to disproportionately occur in those patients with CDH who underwent venoarterial bypass. Further study of retinal vascular changes in patients with CDH should be performed to assess long-term effects.

Duke Scholars

Published In

J AAPOS

DOI

ISSN

1091-8531

Publication Date

December 1997

Volume

1

Issue

4

Start / End Page

235 / 240

Location

United States

Related Subject Headings

  • Retinal Vessels
  • Retinal Hemorrhage
  • Retinal Diseases
  • Respiratory Distress Syndrome, Newborn
  • Ophthalmology & Optometry
  • Meconium Aspiration Syndrome
  • Male
  • Infant, Newborn
  • Humans
  • Hernias, Diaphragmatic, Congenital
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Young, T. L., Quinn, G. E., Baumgart, S., Petersen, R. A., & Schaffer, D. B. (1997). Extracorporeal membrane oxygenation causing asymmetric vasculopathy in neonatal infants. J AAPOS, 1(4), 235–240. https://doi.org/10.1016/s1091-8531(97)90044-6
Young, T. L., G. E. Quinn, S. Baumgart, R. A. Petersen, and D. B. Schaffer. “Extracorporeal membrane oxygenation causing asymmetric vasculopathy in neonatal infants.J AAPOS 1, no. 4 (December 1997): 235–40. https://doi.org/10.1016/s1091-8531(97)90044-6.
Young TL, Quinn GE, Baumgart S, Petersen RA, Schaffer DB. Extracorporeal membrane oxygenation causing asymmetric vasculopathy in neonatal infants. J AAPOS. 1997 Dec;1(4):235–40.
Young, T. L., et al. “Extracorporeal membrane oxygenation causing asymmetric vasculopathy in neonatal infants.J AAPOS, vol. 1, no. 4, Dec. 1997, pp. 235–40. Pubmed, doi:10.1016/s1091-8531(97)90044-6.
Young TL, Quinn GE, Baumgart S, Petersen RA, Schaffer DB. Extracorporeal membrane oxygenation causing asymmetric vasculopathy in neonatal infants. J AAPOS. 1997 Dec;1(4):235–240.
Journal cover image

Published In

J AAPOS

DOI

ISSN

1091-8531

Publication Date

December 1997

Volume

1

Issue

4

Start / End Page

235 / 240

Location

United States

Related Subject Headings

  • Retinal Vessels
  • Retinal Hemorrhage
  • Retinal Diseases
  • Respiratory Distress Syndrome, Newborn
  • Ophthalmology & Optometry
  • Meconium Aspiration Syndrome
  • Male
  • Infant, Newborn
  • Humans
  • Hernias, Diaphragmatic, Congenital