TY - JOUR
T1 - Venovenous versus venoarterial extracorporeal membrane oxygenation among infants with hypoxic-ischemic encephalopathy
T2 - is there a difference in outcome?
AU - for the Children’s Hospital Neonatal Consortium (CHNC) ECMO and HIE focus groups
AU - Agarwal, Prashant
AU - Natarajan, Girija
AU - Sullivan, Kevin
AU - Rao, Rakesh
AU - Rintoul, Natalie
AU - Zaniletti, Isabella
AU - Keene, Sarah
AU - Mietzsch, Ulrike
AU - Massaro, An N.
AU - Billimoria, Zeenia
AU - Dirnberger, Daniel
AU - Hamrick, Shannon
AU - Seabrook, Ruth B.
AU - Weems, Mark F.
AU - Cleary, John P.
AU - Gray, Brian W.
AU - DiGeronimo, Robert
AU - Piazza, Anthony
AU - Sysyn, Gregory
AU - Coghill, Carl
AU - Black, Allison
AU - Dhanireddy, Ramasubbareddy
AU - Hansen, Anne
AU - Hossain, Tanzeema
AU - Murthy, Karna
AU - Falciglia, Gustave
AU - Haberman, Beth
AU - Nathan, Amy
AU - Nelson, Kristin
AU - Kingma, Paul
AU - Riddle, Stefanie
AU - Merhar, Stephanie
AU - Kaplan, Heather
AU - Reber, Kristina
AU - Savani, Rashmin
AU - Brion, Luc
AU - Ali, Noorjahan
AU - Grover, Theresa
AU - Natarajan, Girija
AU - Nedrelow, Jonathan
AU - Chi, Annie
AU - Johnson, Yvette
AU - Suresh, Gautham
AU - Engle, William
AU - Simpson, Lora
AU - Sokol, Gregory
AU - Pallotto, Eugenia
AU - Lyle, Robert
AU - Rogers, Becky
AU - Chin, Steven
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature America, Inc.
PY - 2021/8
Y1 - 2021/8
N2 - Objective: Our hypothesis was that among infants with hypoxic-ischemic encephalopathy (HIE), venoarterial (VA), compared to venovenous (VV), extracorporeal membrane oxygenation (ECMO) is associated with an increased risk of mortality or intracranial hemorrhage (ICH). Design/methods: Retrospective cohort analysis of infants in the Children’s Hospitals Neonatal Database from 2010 to 2016 with moderate or severe HIE, gestational age ≥36 weeks, and ECMO initiation <7 days of age. The primary outcome was mortality or ICH. Results: Severe HIE was more common in the VA ECMO group (n = 57), compared to the VV ECMO group (n = 53) (47.4% vs. 26.4%, P = 0.02). VA ECMO was associated with a significantly higher risk of death or ICH [57.9% vs. 34.0%, aOR 2.39 (1.08–5.28)] and mortality [31.6% vs. 11.3%, aOR 3.06 (1.08–8.68)], after adjusting for HIE severity. Conclusions: In HIE, VA ECMO was associated with a higher incidence of mortality or ICH. VV ECMO may be beneficial in this population.
AB - Objective: Our hypothesis was that among infants with hypoxic-ischemic encephalopathy (HIE), venoarterial (VA), compared to venovenous (VV), extracorporeal membrane oxygenation (ECMO) is associated with an increased risk of mortality or intracranial hemorrhage (ICH). Design/methods: Retrospective cohort analysis of infants in the Children’s Hospitals Neonatal Database from 2010 to 2016 with moderate or severe HIE, gestational age ≥36 weeks, and ECMO initiation <7 days of age. The primary outcome was mortality or ICH. Results: Severe HIE was more common in the VA ECMO group (n = 57), compared to the VV ECMO group (n = 53) (47.4% vs. 26.4%, P = 0.02). VA ECMO was associated with a significantly higher risk of death or ICH [57.9% vs. 34.0%, aOR 2.39 (1.08–5.28)] and mortality [31.6% vs. 11.3%, aOR 3.06 (1.08–8.68)], after adjusting for HIE severity. Conclusions: In HIE, VA ECMO was associated with a higher incidence of mortality or ICH. VV ECMO may be beneficial in this population.
UR - https://www.scopus.com/pages/publications/85106235993
U2 - 10.1038/s41372-021-01089-4
DO - 10.1038/s41372-021-01089-4
M3 - Article
C2 - 34012056
AN - SCOPUS:85106235993
SN - 0743-8346
VL - 41
SP - 1916
EP - 1923
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 8
ER -