부산대학교 도서관

Introduction: Data are limited on use of extracorporeal membrane oxygenation (ECMO) in neonates with pulmonary atresia intact ventricular septum (PAIVS). We aimed to describe ECMO use, risk factors, and associated outcomes in this population.Methods: This is a retrospective analysis of neonates with PAIVS who received ECMO between 2009-2019 in 19 US hospitals affiliated with the Collaborative Research for the Pediatric Cardiac Intensive Care Society (CoRe-PCICS). Patient demographics and clinical, procedural, and imaging data were collected from the medical record. Variables significant on univariate analysis were entered into a logistic regression and a model built to calculate estimated risk of ECMO. A similar analysis compared patients who received ECMO and experienced inpatient mortality to those who did not. A receiver operator curve analysis was conducted to determine the accuracy of this risk score in predicting inpatient mortality. A p-value <0.05 was statistically significant.Results: Of 295 neonates with PAIVS, 32 (11%) were supported with ECMO. By multivariable analyses, a higher left pulmonary artery z-score (OR 2.0; p-value <0.01) and the presence of ventriculocoronary connections by cardiac catheterization (OR 3.4; p-value 0.03) was associated with an increased risk of receiving ECMO. The resulting risk score had an area under the curve of 0.71 for prediction of need for ECMO. Of these 32 ECMO patients, 15 (46%) experienced mortality. By univariate analyses, those who were supported with ECMO, and experienced inpatient mortality had a higher gestational age (p-value 0.04). No significant associations were identified in those supported with ECMO and any independent variable.Conclusions: In a multicenter cohort of patients with pulmonary atresia with intact ventricular septum, 11% received ECMO. Of those supported with ECMO, 46% experienced inpatient mortality. There are risk factors that can help in identifying those who may require ECMO.