2013 - 2020年加利福尼亚州新生儿呼吸体外膜肺氧合的危险因素、发病率及预后，包括与治疗性低温的关联
Risk factors, incidence, and outcomes of neonatal respiratory extracorporeal membrane oxygenation including association with therapeutic hypothermia in California during 2013-2020.
作者信息
Sankaran Deepika, Lee Henry C, Park Lidia, Kan Peiyi, Lakshminrusimha Satyan
机构信息
Division of Neonatology, Department of Pediatrics, University of California Davis, Sacramento, CA, USA.
Division of Neonatology, Department of Pediatrics, University of California San Diego, La Jolla, CA, USA.
出版信息
J Perinatol. 2024 Oct;44(10):1442-1447. doi: 10.1038/s41372-024-02067-2. Epub 2024 Aug 4.
OBJECTIVE
To evaluate the incidence, indications and outcomes with neonatal extracorporeal membrane oxygenation (ECMO) and its association with therapeutic hypothermia (TH) among infants undergoing invasive mechanical ventilation (IMV) in California during 2013-2020.
STUDY DESIGN
We analyzed data on neonates ≥34 weeks gestation with ≥4 h of IMV over an 8-year period (2013-2020) from the California Perinatal Quality Care Collaborative (CPQCC) database.
RESULTS
Between 2013 and 2020, the ranges for utilization of iNO (13.9 to 17.2%), ECMO (2.1 to 2.5%), TH (10.2 to 15.7%) and TH + ECMO (0.4 to 0.8%) were observed. The most common association with neonatal ECMO was TH (148 cases, OR 3.2, 95% CI 2.6-4.3, p < 0.01). The combination of meconium aspiration syndrome (MAS) and hypoxic ischemic encephalopathy (HIE) increased risk of iNO and ECMO use (OR 11.3, 1.5-86.9), p = 0.02).
CONCLUSION
Ventilated infants ≥34 weeks gestational age undergoing TH are at risk for iNO/ECMO use and need close monitoring.
目的
评估2013 - 2020年期间加利福尼亚州接受有创机械通气（IMV）的婴儿中新生儿体外膜肺氧合（ECMO）的发生率、适应证和结局及其与治疗性低温（TH）的关联。
研究设计
我们分析了来自加利福尼亚围产期质量护理协作组织（CPQCC）数据库的2013 - 2020年8年间胎龄≥34周且接受IMV≥4小时的新生儿数据。
结果
2013年至2020年期间，观察到吸入一氧化氮（iNO）（13.9%至17.2%）、ECMO（2.1%至2.5%）、TH（10.2%至15.7%）和TH + ECMO（0.4%至0.8%）的使用范围。与新生儿ECMO最常见的关联是TH（148例，OR 3.2，95%CI 2.6 - 4.3，p < 0.01）。胎粪吸入综合征（MAS）和缺氧缺血性脑病（HIE）的联合增加了使用iNO和ECMO的风险（OR 11.3，1.5 - 86.9），p = 0.02）。
结论
接受TH的胎龄≥34周的通气婴儿有使用iNO/ECMO的风险，需要密切监测。
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