In-Hospital Outcomes Following Extracorporeal Membrane Oxygenation in a Retrospective Cohort of Infants.

OBJECTIVE: We sought to characterize associations between infant characteristics and extracorporeal membrane oxygenation (ECMO) survival using electronic health records data. STUDY DESIGN: We examined a cohort study of infants ≥32 weeks of gestational age and ≥1,800 g birth weight supported with ECMO in a Pediatrix Medical Group neonatal intensive care unit from 1998 to 2013. RESULTS: We identified 268 infants, of which 45 (17%) were <37 weeks of gestational age. Survival to discharge was 87% but was lower in premature compared with term infants (76 vs. 89%, p = 0.03). In multivariable analysis, acute kidney injury (odds ratio [OR] = 4.00; 95% confidence interval [CI] = 1.05, 15.24), postnatal age at cannulation of 7 to 13 days (OR = 5.86; 95% CI = 1.21, 28.44), and venoarterial ECMO cannulation (OR = 4.33; 95% CI = 1.77, 10.60) were associated with lower survival. CONCLUSION: ECMO cannulation type, postnatal age, and acute kidney injury were associated with lower ECMO survival, while prematurity was not. Future studies are needed to identify risk factors and strategies to improve outcomes.

Duke Scholars

Author Rachel Gottron Greenberg Pediatrics, Neonatology

Author Phillip Brian Smith Pediatrics, Neonatology

Author Christoph Paul Vincent Hornik Pediatrics, Critical Care Medicine