Abstract：
BACKGROUND: Traditionally, gestational age <34 wk and weight <2 kg are considered relative contraindications to extracorporeal membrane oxygenation (ECMO). There is a paucity of information that explains the outcomes in this unique population of premature neonates. The purpose of this study is to examine outcomes of patients who undergo ECMO at <34 wk at a single institution.
METHODS: A single-center retrospective review was performed for neonates managed with ECMO in the neonatal intensive care unit from January 2012 to April 2022. Characteristics and outcome data were collected. The primary outcome studied was survival at discharge. Secondary outcomes were intraventricular hemorrhage, ischemic brain injury, and thrombosis. Data were analyzed with descriptive statistics.
RESULTS: Following exclusion, 107 patients were included with eight having initiating ECMO at <34 wk. Three (38%) patients, who received ECMO at <34 wk, incurred intraventricular hemorrhages compared to 14 (14%) in the ≥34-wk cohort. Two (25%), who underwent ECMO at <34 wk, exhibited signs of brain ischemia on imaging compared to 9 (9%) in those ≥34 wk, and 3 (38%) patients <34 wk experienced thrombosis compared to 31 (31%) in the ≥34-wk cohort. Five (63%) of those in the <34-wk cohort survived to discharge, similar to 61 (61%) in the ≥34 wk cohort.
CONCLUSIONS: Our data suggest that EGA <34 wk may not be a contraindication for ECMO, with appropriate counseling of potential risks.
METHODS: A single-center retrospective review was performed for neonates managed with ECMO in the neonatal intensive care unit from January 2012 to April 2022. Characteristics and outcome data were collected. The primary outcome studied was survival at discharge. Secondary outcomes were intraventricular hemorrhage, ischemic brain injury, and thrombosis. Data were analyzed with descriptive statistics.
RESULTS: Following exclusion, 107 patients were included with eight having initiating ECMO at <34 wk. Three (38%) patients, who received ECMO at <34 wk, incurred intraventricular hemorrhages compared to 14 (14%) in the ≥34-wk cohort. Two (25%), who underwent ECMO at <34 wk, exhibited signs of brain ischemia on imaging compared to 9 (9%) in those ≥34 wk, and 3 (38%) patients <34 wk experienced thrombosis compared to 31 (31%) in the ≥34-wk cohort. Five (63%) of those in the <34-wk cohort survived to discharge, similar to 61 (61%) in the ≥34 wk cohort.
CONCLUSIONS: Our data suggest that EGA <34 wk may not be a contraindication for ECMO, with appropriate counseling of potential risks.
摘要：
背景：传统上，胎龄<34wk和体重<2kg被认为是体外膜氧合(ECMO)的相对禁忌症.缺乏信息可以解释这种独特的早产新生儿群体的结果。这项研究的目的是检查在单个机构<34周接受ECMO的患者的预后。
方法：对2012年1月至2022年4月在新生儿重症监护病房接受ECMO管理的新生儿进行了单中心回顾性研究。收集特征和结果数据。研究的主要结果是出院时的生存率。次要结果是脑室内出血，缺血性脑损伤，和血栓形成。对数据进行描述性统计分析。
结果：排除后，纳入107例患者，其中8例患者在<34周开始ECMO。三名（38%）患者，在<34周接受ECMO，与≥34周队列中的14例(14%)相比，发生了脑室内出血。两个（25%），在<34周接受ECMO，在≥34周的患者中，影像学表现出脑缺血征象，与9例（9%）相比，3例(38%)<34周患者发生血栓形成,而≥34周队列中有31例(31%)患者发生血栓形成.<34周队列中有5人(63%)存活出院，在≥34周队列中与61例(61%)相似。
结论：我们的数据表明EGA<34wk可能不是ECMO的禁忌症，对潜在风险进行适当的咨询。
方法：对2012年1月至2022年4月在新生儿重症监护病房接受ECMO管理的新生儿进行了单中心回顾性研究。收集特征和结果数据。研究的主要结果是出院时的生存率。次要结果是脑室内出血，缺血性脑损伤，和血栓形成。对数据进行描述性统计分析。
结果：排除后，纳入107例患者，其中8例患者在<34周开始ECMO。三名（38%）患者，在<34周接受ECMO，与≥34周队列中的14例(14%)相比，发生了脑室内出血。两个（25%），在<34周接受ECMO，在≥34周的患者中，影像学表现出脑缺血征象，与9例（9%）相比，3例(38%)<34周患者发生血栓形成,而≥34周队列中有31例(31%)患者发生血栓形成.<34周队列中有5人(63%)存活出院，在≥34周队列中与61例(61%)相似。
结论：我们的数据表明EGA<34wk可能不是ECMO的禁忌症，对潜在风险进行适当的咨询。
