Friedlich P, Gonzalez J, Nield T, Keshava H, Stein J, Seri I, Gilsanz V
Division of Newborn and Infant Critical Care, Department of Pediatrics, Center for Fetal and Neonatal Medicine, Childrens Hospital Los Angeles, Keck School of Medicine, University of Southern California, CA 90027, USA.
J Perinatol. 2008 Dec;28(12):811-4. doi: 10.1038/jp.2008.107. Epub 2008 Jul 10.
To compare left carotid intima-media thickness (CIMT) and biochemical markers for atherogenesis in neonatal venoarterial extracorporeal membrane oxygenation (ECMO) survivors with normal controls during childhood.
Venoarterial ECMO survivors and healthy patients between 12 and 18 years of age were enrolled in a matched control prospective study. ECMO survivors were matched to controls based on chronological age and percentage of body mass index (BMI). Measured CIMT of the posterior left carotid artery and CIMT values corrected for carotid artery size were used for data analysis.
Thirty-one neonatal venoarterial ECMO survivors were matched to 31 healthy controls. No significant differences were found between ECMO survivors and controls for age, weight, percentage of BMI, total fat composition, lipid profiles, ultrasensitive C-reactive protein or homocysteine levels. Significant differences between ECMO and controls patients were found in systolic, diastolic and mean left CIMT.
Compared with controls, the thickness of the left carotid intima media is significantly increased at the age of 12 to 18 years in neonatal venoarterial ECMO survivors. The clinical significance of this increased CIMT is unknown. ECMO centers may want to incorporate assessment of CIMT in their follow-up protocols.
比较新生儿静脉-动脉体外膜肺氧合(ECMO)幸存者与正常对照儿童在童年期的左颈动脉内膜中层厚度(CIMT)及动脉粥样硬化发生的生化标志物。
12至18岁的静脉-动脉ECMO幸存者和健康患者纳入一项匹配对照前瞻性研究。根据实足年龄和体重指数(BMI)百分比将ECMO幸存者与对照组进行匹配。测量左颈后动脉的CIMT以及校正颈动脉大小后的CIMT值用于数据分析。
31名新生儿静脉-动脉ECMO幸存者与31名健康对照匹配。在年龄、体重、BMI百分比、总脂肪成分、血脂谱、超敏C反应蛋白或同型半胱氨酸水平方面,ECMO幸存者与对照组之间未发现显著差异。在收缩期、舒张期及左CIMT平均值方面,ECMO患者与对照组存在显著差异。
与对照组相比,新生儿静脉-动脉ECMO幸存者在12至18岁时左颈动脉内膜中层厚度显著增加。这种CIMT增加的临床意义尚不清楚。ECMO中心可能希望在其随访方案中纳入CIMT评估。