Texas Tech University Health Sciences Center, Amarillo, TX, USA.
Mercy Health West Hospital, Cincinnati, OH, USA.
J Perinatol. 2018 Aug;38(8):1106-1113. doi: 10.1038/s41372-018-0129-4. Epub 2018 May 24.
To determine trends in neonatal extracorporeal membrane oxygenation (ECMO) utilization from 2002-2011.
Using the Nationwide inpatient sample (NIS), we conducted a population-based retrospective cohort study to identify ECMO utilization among neonates. Incidence of ECMO utilization, length of stay (LOS), cost and mortality were estimated.
In all, 33,367,146 neonates were identified of which 7603 (18 per 100,000 live births) underwent ECMO. Neonatal ECMO increased from 12 to 23 runs per 100,000 live births. Mortality was 48.4%, decreasing from 47.5 to 41.9% between 2002 and 2011. On multivariate analysis, mortality was significantly higher for infectious indications (OR 4.1; CI 1.1-16.0), E-CPR (OR 3.8; CI 1.4-10.7) and cardiac indications (OR 2.0; CI 1.5-2.8). On hierarchical regression, LOS increased by 1.6 days each year (p = 0.02) and cost of hospitalization increased by $14,033 each year (p < 0.0001).
Neonatal ECMO utilization increased, while mortality decreased during the study period. These findings suggest an improvement in neonatal ECMO care.
确定 2002 年至 2011 年新生儿体外膜肺氧合（ECMO）应用的趋势。
利用全国住院患者样本（NIS），我们进行了一项基于人群的回顾性队列研究，以确定新生儿 ECMO 的应用情况。估计 ECMO 的应用率、住院时间（LOS）、成本和死亡率。
共确定了 33367146 例新生儿，其中 7603 例（每 10 万活产儿中有 18 例）接受了 ECMO。新生儿 ECMO 从 12 次增加到 23 次/10 万活产儿。死亡率为 48.4%，2002 年至 2011 年期间从 47.5%降至 41.9%。多变量分析显示，感染性指征（OR 4.1；CI 1.1-16.0）、E-CPR（OR 3.8；CI 1.4-10.7）和心脏指征（OR 2.0；CI 1.5-2.8）的死亡率显著更高。在分层回归中，每年 LOS 增加 1.6 天（p=0.02），住院费用每年增加 14033 美元（p<0.0001）。
在研究期间，新生儿 ECMO 的应用增加，而死亡率下降。这些发现表明新生儿 ECMO 治疗有所改善。
