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Titolo:
International experience with trisomy 21 infants placed on extracorporeal membrane oxygenation
Autore:
Southgate, WM; Annibale, DJ; Hulsey, TC; Purohit, DM;
Indirizzi:
Med Univ S Carolina, Dept Pediat, Div Neonatol, Charleston, SC 29425 USA Med Univ S Carolina Charleston SC USA 29425 tol, Charleston, SC 29425 USA
Titolo Testata:
PEDIATRICS
fascicolo: 3, volume: 107, anno: 2001,
pagine: 549 - 552
SICI:
0031-4005(200103)107:3<549:IEWT2I>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
PULMONARY VASCULAR-DISEASE; ATRIOVENTRICULAR SEPTAL-DEFECT; DOWNS-SYNDROME; CARDIAC CARE; CHILDREN; ATTITUDES; NEWBORNS; REPAIR;
Keywords:
neonate; extracorporeal membrane oxygenation; trisomy 21; persistent pulmonary hypertension;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Southgate, WM Med Univ S Carolina, Dept Pediat, Div Neonatol, 165 Ashley Ave,Box 250917,Charleston, SC 29425 USA Med Univ S Carolina 165 Ashley Ave,Box 250917 Charleston SC USA 29425
Citazione:
W.M. Southgate et al., "International experience with trisomy 21 infants placed on extracorporeal membrane oxygenation", PEDIATRICS, 107(3), 2001, pp. 549-552

Abstract

Objective. To characterize the international experience concerning neonates with trisomy 21 (T21) managed with extracorporeal membrane oxygenation (ECMO), and to compare and contrast this group of patients to the neonatal ECMO population as a whole. Methods. Data from the Extracorporeal Life Support Organization for newborn infants placed on ECMO between January 1984 and June 1999 were analyzed. Infants with T21 were compared with the group of infants without T21. Results. Fifteen thousand nine hundred forty-six infants, including 91 (n = 91) with the diagnosis of T21, were placed on ECMO for neonatal respiratory failure during the 14.5-year period. T21 infants were overrepresented inthe ECMO population by several-fold when compared with the incidence of T21 in the general population. Eighty-seven of the 91 T21 infants were placedon ECMO after 1989. The distribution of primary diagnoses leading to ECMO differed between the groups (T21 vs non-T21): primary persistent pulmonary hypertension, 47.3% versus 13%; meconium aspiration syndrome, 23.1% versus 32.9%; sepsis, 7.7% versus 13.2%; congenital diaphragmatic hernia, 7.7% versus 19.9%; and respiratory distress syndrome, 3.3% versus 7.9%. Although survival to discontinuation of ECMO was similar in the 2 groups, likelihood of survival to discharge was decreased for T21 infants (65.9% vs 75.6%) because of increased post-ECMO mortality. Conclusions. Extracorporeal Life Support Organization registry data suggests that T21 infants are at a significantly higher risk of being placed on ECMO for neonatal respiratory failure than the general population, perhaps as a result of delayed extrauterine pulmonary vascular adaptation, as manifested in the high rate of primary persistent pulmonary hypertension as the primary diagnosis. There may have been a shift in attitude regarding the useof ECMO in the T21 patient after 1989. Although most T21 patients placed on ECMO will survive, the prognosis is more guarded in this population when compared with all infants so managed. The longterm neurodevelopmental outcome of this group of T21 ECMO survivors is currently unknown.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 13:34:25