Flusser H, Dodge N N, Engle W E, Garg B P, West K W
Department of Pediatrics, Indiana University Hospitals, Indianapolis.
J Perinatol. 1993 Jul-Aug;13(4):266-71.
Outcome at 1 year was evaluated in 37 neonates treated with extracorporeal membrane oxygenation (ECMO) between June 1987 and March 1989. Thirty of 37 survived, and 7 of 30 showed major abnormalities in respiratory status, neurologic examination, or developmental status. Abnormal respiratory status was defined as need for supplemental oxygen, tracheostomy, or mechanical ventilation, and developmental delay was defined as developmental quotient < 70 on either the Mental or Psychomotor scale of the Bayley Scales of Infant Development. Five of seven children with major abnormalities were affected in more than one system. Adverse outcome was associated with the presence of congenital anomalies. Perinatal factors including Apgar scores, last pH before starting extracorporeal membrane oxygenation, and number of hours on ECMO did not show a significant correlation with Bayley scores. Computed tomography and electroencephalography of neonates showed no relationship to Bayley scores or neurologic examination. In conclusion, a small subgroup of patients accounts for the majority of abnormal findings at 1 year, and the presence of congenital anomalies appears to increase the risk for abnormal outcome.
对1987年6月至1989年3月期间接受体外膜肺氧合（ECMO）治疗的37例新生儿进行了1年时的预后评估。37例中有30例存活，30例中的7例在呼吸状态、神经系统检查或发育状态方面存在主要异常。异常呼吸状态定义为需要补充氧气、气管切开或机械通气，发育迟缓定义为贝利婴儿发育量表的智力或心理运动量表上发育商<70。7例有主要异常的儿童中有5例在多个系统受到影响。不良预后与先天性异常的存在有关。围产期因素，包括阿氏评分、开始体外膜肺氧合前的最后pH值以及在ECMO上的小时数，与贝利评分无显著相关性。新生儿的计算机断层扫描和脑电图与贝利评分或神经系统检查无关。总之，一小部分患者占1年时大多数异常发现，先天性异常的存在似乎增加了异常预后的风险。
