학술논문

Current Practices for Genetic Testing in Neonatal Extracorporeal Membrane Oxygenation: Findings from a National survey.
Document Type
Article
Source
Perfusion. Jan2024, Vol. 39 Issue 1, p116-123. 8p.
Subject
*RESPIRATORY insufficiency
*SEQUENCE analysis
*NEONATAL intensive care
*HEALTH services accessibility
*CRITICALLY ill
*CROSS-sectional method
*EXTRACORPOREAL membrane oxygenation
*GENETIC testing
*PATIENTS
*NEONATAL intensive care units
*MEDICAL care costs
*COST control
*TREATMENT effectiveness
*SURVEYS
*SEVERITY of illness index
*GENOMES
*DESCRIPTIVE statistics
*CHILDREN
Language
ISSN
0267-6591
Abstract
Introduction: Comprehensive genetic testing with whole-exome (WES) or whole-genome (WGS) sequencing facilitates diagnosis, can optimize treatment, and may improve outcomes in critically ill neonates, including those requiring extracorporeal membrane oxygenation (ECMO) for respiratory failure. Our objective was to describe practice variation and barriers to the utilization of comprehensive genetic testing for neonates on ECMO. Methods: We performed a cross-sectional survey of Level IV neonatal intensive care units in the United States across the Children's Hospitals Neonatal Consortium (CHNC). Results: Common indications for WES and WGS included concerning phenotype, severity of disease, unexpected postnatal clinical course, and inability to wean from ECMO support. Unexpected severity of disease on ECMO was the most common indication for rapid genetic testing. Cost of utilization was the primary barrier to testing. If rapid WES or WGS were readily available, 63% of centers would consider incorporating universal screening for neonates upon ECMO cannulation. Conclusion: Despite variation in the use of WES and WGS, universal testing may offer earlier diagnosis and influence the treatment course among neonates on ECMO. Cost is the primary barrier to utilization and most centers would consider incorporating universal screening on ECMO if readily available. [ABSTRACT FROM AUTHOR]