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- Pulmonary Sequelae at Six Months following Extracorporeal Membrane Oxygenation (13)

Pulmonary Sequelae at Six Months following Extracorporeal Membrane Oxygenation (13)Oxygenation assessed noninvasively during sleep, feeding and wakefulness was normal in all infants at 6 months of age. Although 67 percent of ECMO survivors experienced short periods of apnea of 4- 10-s duration, none of these episodes was clinically significant. No episode of severe desaturation less than 90 percent (equivalent to Pa02 of 60 mm Hg) was observed, as have been previously described in infants with chronic lung disease. These findings may suggest less severe lung disease in ECMO survivors than in infants with BPD following prematurity. This is further supported by the fact that the Cdyn measurements in ECMO survivors were significantly better than those of preterm BPD infants. Swaminathan et al have reported that long-term pulmonary function abnormalities following meconium aspiration syndrome in term infants are less severe than those following BPD in preterm infants. Since ECMO patients are, by definition, near-term infants, one would expect residual chronic lung disease to be milder than that seen in preterm BPD survivors.
All infants had severe abnormalities in gas exchange during the neonatal period. Since there was little variation in these abnormalities, it is not possible to analyze their correlation to the pulmonary function abnormalities observed at 6 months of age. The hours spent on ECMO and hours of assisted mechanical ventilation required after ECMO were not predictive of pulmonary function abnormalities at 6 months of age. Therefore, the development of chronic lung disease in ECMO survivors is associated, at least in part, with factors other than the severity of initial lung injury and the type and duration of treatment.
In summary, ECMO and lung rest treatment for severe neonatal respiratory failure do not prevent the development of pulmonary sequelae at 6 months of age; however, they may reduce the severity of chronic lung disease in neonatal lung injury.

August 27, 2013 Pulmonary function
Tags: chronic lung disease mechanical ventilation neonatal respiratory failure pulmonary function respiratory failure