Objective:To evaluate the effects of pre-extracorporeal life support (ECLS) management with nitric oxide (NO),high frequency ventilation (HFV),and surfactant on mortality among neonates supported with ECLS. Study desi...Objective:To evaluate the effects of pre-extracorporeal life support (ECLS) management with nitric oxide (NO),high frequency ventilation (HFV),and surfactant on mortality among neonates supported with ECLS. Study design:Extracorporeal Life Support Organization (ELSO) data on 7017 neonates cannulated for respiratory reasons between 1996 and 2003 were analyzed using χ2,analysis of variance,and logistic regression.Results:The use of ECLS declined by 26.6%over the studyperiod with no significant change in mortality. Unadjusted ECLS mortality for NO-treated patients was lower than for infants not treated with NO (25.1%vs 28.6%,P = 0.0012) and for infants treated with surfactant than for infants not treated with surfactant (18.7%vs 30.3%,p <0.0001) Unadjusted mortality for HFV-treated patients was no different than for non-HFV treated patients (26.0%vs 26.6%,P=0.56). After adjusting for confounders (primary diagnosis,age at cannulation,ECMO year 1996-1999 vs 2000-2003),surfactant use was associated with decreased mortality. NO-treated neonates were less likely to have a pre-ECLS cardiopulmonary arrest than infants not treated with NO. NO,HFV,and surfactant were not associated with prolongation of ECLS or mechanical ventilation. Conclusions:NO,HFV,and surfactant were not associated within creased mortality in neonates who require ECLS for hypoxic respiratory failure.展开更多
文摘Objective:To evaluate the effects of pre-extracorporeal life support (ECLS) management with nitric oxide (NO),high frequency ventilation (HFV),and surfactant on mortality among neonates supported with ECLS. Study design:Extracorporeal Life Support Organization (ELSO) data on 7017 neonates cannulated for respiratory reasons between 1996 and 2003 were analyzed using χ2,analysis of variance,and logistic regression.Results:The use of ECLS declined by 26.6%over the studyperiod with no significant change in mortality. Unadjusted ECLS mortality for NO-treated patients was lower than for infants not treated with NO (25.1%vs 28.6%,P = 0.0012) and for infants treated with surfactant than for infants not treated with surfactant (18.7%vs 30.3%,p <0.0001) Unadjusted mortality for HFV-treated patients was no different than for non-HFV treated patients (26.0%vs 26.6%,P=0.56). After adjusting for confounders (primary diagnosis,age at cannulation,ECMO year 1996-1999 vs 2000-2003),surfactant use was associated with decreased mortality. NO-treated neonates were less likely to have a pre-ECLS cardiopulmonary arrest than infants not treated with NO. NO,HFV,and surfactant were not associated with prolongation of ECLS or mechanical ventilation. Conclusions:NO,HFV,and surfactant were not associated within creased mortality in neonates who require ECLS for hypoxic respiratory failure.
