UCL logo

UCL Discovery

UCL home » Library Services » Electronic resources » UCL Discovery

Outcome in neonates with congenital heart disease referred for respiratory extracorporeal membrane oxygenation

Brown, KL; Miles, F; Sullivan, ID; Hoskote, A; Verhulst, L; Ridout, DA; Goldman, AP; (2005) Outcome in neonates with congenital heart disease referred for respiratory extracorporeal membrane oxygenation. ACTA PAEDIATR , 94 (9) 1280 - 1284. 10.1080/08035250510035193.

Full text not available from this repository.

Abstract

Aim: To evaluate the proportion of neonates referred for extracorporeal membrane oxygenation (ECMO) support in the modern era of advanced conventional treatments for respiratory failure who actually had congenital heart disease (CHD), and to assess the impact of this diagnostic route on patient condition and outcome. Methods: A retrospective case-note review of neonatal ECMO and cardiac admissions to a single, tertiary ECMO and cardiac intensive care unit (ICU) between March 1999 and February 2002. Results: 287 symptomatic neonates presented to the ICU with previously undiagnosed cardiac or respiratory disease. Eighty-two with presumed respiratory failure were referred for ECMO, and 205 with suspected CHD were referred for cardiac evaluation. Eight (10%) ECMO referrals, all with presumed persistent pulmonary hypertension of the newborn (PPHN), were found to have CHD(transposition: 3; total anomalous pulmonary venous connection: 3; left heart obstructive lesions: 2). Mortality in this group was 50%, compared with 11% for correctly identified CHD patients (odds ratio 8.2, 95% CI 1.92, 35.4, p < 0.01). For all neonates with CHD, the risk of death was increased by the presence of cardiovascular collapse and end-organ dysfunction at presentation to the ICU (p < 0.01 for both).Conclusion: Neonates with CHD may present as severe "PPHN" via the ECMO service. Poor outcome in these patients relates to the high incidence of cardiovascular collapse and end-organ dysfunction. Early echocardiography is recommended for neonates with presumed PPHN. Neonatal ECMO support should be based in centres with cardiac surgical services.

Type: Article
Title: Outcome in neonates with congenital heart disease referred for respiratory extracorporeal membrane oxygenation
DOI: 10.1080/08035250510035193
Keywords: cardiac surgery, congenital heart disease, extracorporeal membrane oxygenation, neonatal intensive care, PERSISTENT PULMONARY-HYPERTENSION, INHALED NITRIC-OXIDE, PREDICTION MODEL, GREAT-ARTERIES, MORTALITY, SURGERY, TRANSPOSITION, MANAGEMENT, CHILDREN, NEWBORN
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health > ICH Pop, Policy and Practice Prog
URI: http://discovery.ucl.ac.uk/id/eprint/1305103
Downloads since deposit
0Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item